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

Research output: Contribution to journalArticlepeer-review

36 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 languageEnglish
Pages (from-to)83-90
Number of pages8
JournalNeonatology
Volume101
Issue number2
DOIs
Publication statusPublished - 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

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