Amniopatch Treatment for Spontaneous Previable, Preterm Premature Rupture of Membranes Associated or Not with Incompetent Cervix

• Published in: Fetal diagnosis and therapy Vol. 33; no. 1; pp. 47 - 54
• Main Authors: Kwak, Hye-Min, Choi, Hyun-Jin, Cha, Hyun-Hwa, Yu, Hee-Jun, Lee, Jee-Hun, Choi, Suk-Joo, Oh, Soo-young, Roh, Cheong-Rae, Kim, Jong-Hwa
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland Karger 01.01.2013; S. Karger AG
• Subjects: Adult; Biological and medical sciences; Blood Transfusion, Autologous; Delivery. Postpartum. Lactation; Diseases of mother, fetus and pregnancy; Disorders; Female; Fetal Membranes, Premature Rupture - etiology; Fetal Membranes, Premature Rupture - surgery; General aspects; Gynecology. Andrology. Obstetrics; Humans; Medical sciences; Original Paper; Plasmapheresis; Platelet Transfusion; Pregnancy; Pregnancy. Fetus. Placenta; Premature Birth - prevention & control; Retrospective Studies; Uterine Cervical Incompetence; Amniopatch; Previable gestational age; Spontaneous preterm premature rupture of membranes; Pregnancy disorders; Spontaneous; Premature rupture of membrane; Neonatology; Incompetent cervix; Abortion; Gestational age; Medicine; Treatment; Delivery disorders
• ISSN: 1015-3837; 1421-9964
• DOI: 10.1159/000342418

Objective: We reviewed women with previable spontaneous premature rupture of membranes (sPPROM) in whom an amniopatch was performed and compared their pregnancy outcomes with a conservative management group. Methods: Amniopatch, an amnioinfusion of autologous platelet concentrate followed by cryoprecipitate, was performed in 7 women with sPPROM diagnosed at 17–23 weeks’ gestation, including one twin pregnancy. Three patients had incompetent cervices and the other 4 patients had sPPROM without incompetent cervices. Pregnancy outcomes of the cases were compared with the controls who were managed conservatively (n = 22). Results: Amniopatch treatment was successful in 1 of 7 cases (14.3%), in which the ruptured membranes were completely sealed and the patient delivered a healthy baby at 39 weeks’ gestation. No procedure-related complications were observed. Overall, neonatal outcome was similar in the amniopatch and conservatively managed groups, although the incidences of early neonatal sepsis and respiratory distress syndrome were lower in the amniopatch group. Conclusion: The overall success rate of amniopatch among our small number of cases was low. However, if successful, amniopatch may prolong a pregnancy with previable sPPROM to term.