Pulmonary Effects of Prolonged Oligohydramnios following Mid-Trimester Rupture of the Membranes – Antenatal and Postnatal Management

Olivia Williams; Graham Hutchings; Corinne Hubinont; Christian Debauche; Anne Greenough

doi:10.1159/000329445

Pulmonary Effects of Prolonged Oligohydramnios following Mid-Trimester Rupture of the Membranes – Antenatal and Postnatal Management

Olivia Williams^*, Graham Hutchings, Corinne Hubinont, Christian Debauche, Anne Greenough

^*Corresponding author for this work

King's College London

Research output: Contribution to journal › Article › peer-review

37 Citations (Scopus)

Abstract

Mid-trimester, preterm prelabour rupture of the membranes (PPROM) with prolonged oligohydramnios remains a challenge for both obstetricians and neonatologists. Although survival rates have improved, morbidity remains common particularly due to pulmonary insufficiency and pulmonary hypertension. The aetiology of abnormal lung development is unknown but may depend critically on pulmonary vascular development. Antenatal evaluation of at-risk foetuses by three-dimensional ultrasound and MRI is possible but the techniques need to be further assessed. Antenatal corticosteroids given in cases of PPROM reduce the incidence of neonatal death, respiratory distress syndrome, intraventricular haemorrhage and necrotising enterocolitis without increasing maternal or neonatal infection. The true risk-benefit ratio of antibiotics, tocolysis and strategies to normalise amniotic fluid volume remains less clear. There is no consensus regarding the optimal ventilation strategy to support infants with pulmonary insufficiency following PPROM, and further work is required to determine whether and which pulmonary vasodilators improve long-term outcome in these infants.

Original language	English
Pages (from-to)	83-90
Number of pages	8
Journal	Neonatology
Volume	101
Issue number	2
DOIs	https://doi.org/10.1159/000329445
Publication status	Published - Feb 2012

Keywords

FETAL BREATHING MOVEMENTS
BRONCHOPULMONARY DYSPLASIA
PRELABOR RUPTURE
FREQUENCY OSCILLATORY VENTILATION
INHALED NITRIC-OXIDE
LUNG GROWTH
Oligohydramnios
PRETERM PREMATURE RUPTURE
CONGENITAL DIAPHRAGMATIC-HERNIA
RESPIRATORY-FAILURE
Persistent pulmonary hypertension of the newborn
Preterm prelabour rupture of the membranes
Pulmonary hypoplasia
GESTATIONAL-AGE

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1159/000329445

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title = "Pulmonary Effects of Prolonged Oligohydramnios following Mid-Trimester Rupture of the Membranes – Antenatal and Postnatal Management",

abstract = "Mid-trimester, preterm prelabour rupture of the membranes (PPROM) with prolonged oligohydramnios remains a challenge for both obstetricians and neonatologists. Although survival rates have improved, morbidity remains common particularly due to pulmonary insufficiency and pulmonary hypertension. The aetiology of abnormal lung development is unknown but may depend critically on pulmonary vascular development. Antenatal evaluation of at-risk foetuses by three-dimensional ultrasound and MRI is possible but the techniques need to be further assessed. Antenatal corticosteroids given in cases of PPROM reduce the incidence of neonatal death, respiratory distress syndrome, intraventricular haemorrhage and necrotising enterocolitis without increasing maternal or neonatal infection. The true risk-benefit ratio of antibiotics, tocolysis and strategies to normalise amniotic fluid volume remains less clear. There is no consensus regarding the optimal ventilation strategy to support infants with pulmonary insufficiency following PPROM, and further work is required to determine whether and which pulmonary vasodilators improve long-term outcome in these infants.",

keywords = "FETAL BREATHING MOVEMENTS, BRONCHOPULMONARY DYSPLASIA, PRELABOR RUPTURE, FREQUENCY OSCILLATORY VENTILATION, INHALED NITRIC-OXIDE, LUNG GROWTH, Oligohydramnios, PRETERM PREMATURE RUPTURE, CONGENITAL DIAPHRAGMATIC-HERNIA, RESPIRATORY-FAILURE, Persistent pulmonary hypertension of the newborn, Preterm prelabour rupture of the membranes, Pulmonary hypoplasia, GESTATIONAL-AGE",

author = "Olivia Williams and Graham Hutchings and Corinne Hubinont and Christian Debauche and Anne Greenough",

note = "Copyright {\textcopyright} 2011 S. Karger AG, Basel.",

year = "2012",

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doi = "10.1159/000329445",

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AU - Hutchings, Graham

AU - Hubinont, Corinne

AU - Debauche, Christian

AU - Greenough, Anne

PY - 2012/2

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N2 - Mid-trimester, preterm prelabour rupture of the membranes (PPROM) with prolonged oligohydramnios remains a challenge for both obstetricians and neonatologists. Although survival rates have improved, morbidity remains common particularly due to pulmonary insufficiency and pulmonary hypertension. The aetiology of abnormal lung development is unknown but may depend critically on pulmonary vascular development. Antenatal evaluation of at-risk foetuses by three-dimensional ultrasound and MRI is possible but the techniques need to be further assessed. Antenatal corticosteroids given in cases of PPROM reduce the incidence of neonatal death, respiratory distress syndrome, intraventricular haemorrhage and necrotising enterocolitis without increasing maternal or neonatal infection. The true risk-benefit ratio of antibiotics, tocolysis and strategies to normalise amniotic fluid volume remains less clear. There is no consensus regarding the optimal ventilation strategy to support infants with pulmonary insufficiency following PPROM, and further work is required to determine whether and which pulmonary vasodilators improve long-term outcome in these infants.

AB - Mid-trimester, preterm prelabour rupture of the membranes (PPROM) with prolonged oligohydramnios remains a challenge for both obstetricians and neonatologists. Although survival rates have improved, morbidity remains common particularly due to pulmonary insufficiency and pulmonary hypertension. The aetiology of abnormal lung development is unknown but may depend critically on pulmonary vascular development. Antenatal evaluation of at-risk foetuses by three-dimensional ultrasound and MRI is possible but the techniques need to be further assessed. Antenatal corticosteroids given in cases of PPROM reduce the incidence of neonatal death, respiratory distress syndrome, intraventricular haemorrhage and necrotising enterocolitis without increasing maternal or neonatal infection. The true risk-benefit ratio of antibiotics, tocolysis and strategies to normalise amniotic fluid volume remains less clear. There is no consensus regarding the optimal ventilation strategy to support infants with pulmonary insufficiency following PPROM, and further work is required to determine whether and which pulmonary vasodilators improve long-term outcome in these infants.

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KW - FREQUENCY OSCILLATORY VENTILATION

KW - INHALED NITRIC-OXIDE

KW - LUNG GROWTH

KW - Oligohydramnios

KW - PRETERM PREMATURE RUPTURE

KW - CONGENITAL DIAPHRAGMATIC-HERNIA

KW - RESPIRATORY-FAILURE

KW - Persistent pulmonary hypertension of the newborn

KW - Preterm prelabour rupture of the membranes

KW - Pulmonary hypoplasia

KW - GESTATIONAL-AGE

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DO - 10.1159/000329445

M3 - Article

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SN - 1661-7800

VL - 101

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JO - Neonatology

JF - Neonatology

IS - 2

ER -

Pulmonary Effects of Prolonged Oligohydramnios following Mid-Trimester Rupture of the Membranes – Antenatal and Postnatal Management

Abstract

Keywords

UN SDGs

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