Transabdominal amnioinfusion for improving fetal outcomes after oligohydramnios secondary to preterm prelabour rupture of membranes before 26 weeks

Babies born after preterm prelabour rupture of membranes (PPROM) between 16 and 26 weeks of pregnancy are prone to underdevelopment of the lungs. When the membranes containing the fluid that surrounds the baby (amniotic fluid) rupture, a shortage of this fluid can occur, a condition that is called oligohydramnios. Oligohydramnios is thought to interfere with normal lung development so that it is delayed, resulting in a condition that is called pulmonary hypoplasia.

Pulmonary hypoplasia can present as severe breathing problems or as milder and even transient breathing problems. It can be accompanied by bleeding in the lung and can also result in chronic breathing problems due to scarring of lung tissue. There may also be neurological complications, fetal deformities and neonatal sepsis with oligohydramnios.

Replacement of fluid via a needle passed through the abdominal wall in the uterine cavity and into a pocket of amniotic fluid, (transabdominal amnioinfusion) under ultrasound guidance has been proposed to improve pregnancy outcome. Most clinical experience suggests that amnioinfusion is safe for both the mother and the baby, however, we did not identify any randomised trials of transabdominal amnioinfusion following PPROM before 26 weeks for inclusion in this review. Currently, there is no evidence to evaluate the use of transabdominal amnioinfusion in women with oligohydramnios following  rupture of fetal membranes before 26 weeks for improving birth outcomes.

Authors' conclusions: 

There is currently no evidence to evaluate the use of transabdominal amnioinfusion in women with oligohydramnios secondary to rupture of fetal membranes before 26 weeks for improving perinatal outcome. Further research examining the effects of this intervention is needed. Two randomised controlled trials are ongoing but final data have not yet been published.

Read the full abstract...
Background: 

Preterm prelabour rupture of membranes (PPROM) before 26 weeks can delay lung development and can cause pulmonary hypoplasia, as a result of oligohydramnios. Restoring the amniotic fluid volume by transabdominal amnioinfusion might prevent abnormal lung development and might have a protective effect for neurological complications, fetal deformities and neonatal sepsis.

Objectives: 

To assess the effectiveness of transabdominal amnioinfusion in improving perinatal outcome in women with oligohydramnios secondary to rupture of fetal membranes before 26 weeks.

Search strategy: 

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 April 2013).

Selection criteria: 

All randomised controlled trials comparing transabdominal amnioinfusion with no transabdominal amnioinfusion. Cluster- or quasi-randomised trials were not eligible for inclusion. In cases where only an abstract was available, we attempted to find the full articles.

Data collection and analysis: 

Two review authors assessed trials for inclusion. No eligible trials were identified.

Main results: 

There are no included studies.

Share/Save