Archives of Gynecology and Obstetrics

, Volume 276, Issue 1, pp 87–89

Successful outcome following pre-viability amniorrhexis

Case Report

Abstract

A 34-years-old primigravida conceived following a fourth attempt at in vitro fertilization and embryo transfer for severe bilateral tubal disease and grade IV endometriosis. Pregnancy progressed well until 17 weeks gestation when she spontaneously ruptured her membranes. She elected to continue with the pregnancy despite the significant risks associated with prolonged rupture of membranes (PROM) and anhydramnion at extremes of viability. Pregnancy was carried to 28 weeks gestation, when delivery was necessitated by a major antepartum haemorrhage following abruption placentae. A male infant weighing 1,100 g was delivered by emergency caesarean section in good condition, and with no features oligohydramnion tetrad (Potter’s features, skeletal deformities, intrauterine growth restriction, and pulmonary hypoplasia). This case adds to the small number of cases in the literature of successful outcome following prolonged pre-viability PROM. Counselling and psychological support to the parents in this situation is extremely important since the anxiety and uncertainty associated with expectant management of PROM does not end with the “successful” delivery of the baby but persists all through the neonatal period and for several years later.

Keywords

Pre-viability rupture of membranes Amniorrhexis PPROM 

References

  1. 1.
    Papantoniou NE, Antsaklis AJ, Protopapas AG, Vogiatzi AI, Aravantinos DI (1997) Predictive value of amniotic fluid and fetal blood cultures in pregnancy outcome in preterm prelabour rupture of membranes. J Obstet Gynaecol 17(1):18–22PubMedCrossRefGoogle Scholar
  2. 2.
    Hadi HA, Hodson CA, Strickland D (1994) Premature rupture of the membranes between 20 and 25 weeks’ gestation: role of amniotic fluid volume in perinatal outcome. Am J Obstet Gynecol 170(4):1139–1144PubMedGoogle Scholar
  3. 3.
    Stewart CJ, Tregoning SK, Moller G, Wainwright H (2005) Preterm prelabour rupture of the membranes before 28 weeks: better than feared outcome of expectant management in Africa. Eur J Obstet Gynecol Reprod Biol 126:186–192PubMedCrossRefGoogle Scholar
  4. 4.
    Carroll SG, Ville Y, Greenough A, Gamsu H, Patel B, Philpott-Howard J, Nicolaides KH (1995) Preterm prelabour amniorrhexis: intrauterine infection and interval between membrane rupture and delivery. Arch Dis Child Fetal Neonatal Ed 72(1):43–46CrossRefGoogle Scholar
  5. 5.
    Hnat MD, Mercer BM, Thurnau G, Goldenberg R, Thou EA, Meis PJ, Moawad AH, Iams JD, Van Dorsten JP (2005) Perinatal outcomes in women with preterm rupture of membranes between 24 and 32 weeks of gestation and a history of vaginal bleeding. Am J Obstet Gynecol 193(1):164–168PubMedCrossRefGoogle Scholar
  6. 6.
    Major CA, de Veciana M, Lewis DF, Morgan MA (1995) Preterm premature rupture of membranes and abruptio placentae: is there an association between these pregnancy complications? Am J Obstet Gynecol 172(21):672–676PubMedCrossRefGoogle Scholar
  7. 7.
    Rotschild A, Ling EW, Puterman ML, Farquharson D (1990) Neonatal outcome after prolonged preterm rupture of the membranes. Am J Obstet Gynecol 162(1):46–52PubMedGoogle Scholar
  8. 8.
    Marret H, Descamps P, Fignon A, Perrotin F, Body G, Lansac J (1998) Management of premature rupture of membranes in a monofetal pregnancy before 28 weeks gestation. J Gynecol Obstet Biol Reprod (Paris) Rev 27(7):665–675Google Scholar
  9. 9.
    Shumway JB, Al-Malta A, Amon E, Cohlan B, Amini S, Abboud M, Winn HN (1999) Impact of oligohydramnios on maternal and perinatal outcomes of spontaneous premature rupture of the membranes at 18–28 weeks. J Matern Fetal Med 8(1):20–23PubMedCrossRefGoogle Scholar
  10. 10.
    Garite TJ (1985) Premature rupture of the membranes: the enigma of the obstetrician. Am J Obstet Gynecol 151(8):1001–1005PubMedGoogle Scholar
  11. 11.
    Kilbride HW, Yeast J, Thibeault DW (1996) Defining limits of survival: lethal pulmonary hypoplasia after midtrimester premature rupture of membranes. Am J Obstet Gynecol 175(31):675–681PubMedCrossRefGoogle Scholar
  12. 12.
    Yang LC, Taylor DR, Kaufman HH, Hume R, Calhoun B (2004) Maternal and fetal outcomes of spontaneous preterm premature rupture of membranes. J Am Osteopath Assoc 104(12):537–542PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  1. 1.Department of Obstetrics and GynaecologySt Helier HospitalCarshaltonUK
  2. 2.Assisted Conception UnitSt Helier HospitalCarshaltonUK
  3. 3.St Helier HospitalCarshaltonUK

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