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2001-12-27-10 Serial amnioinfusion © Guerrero www.thefetus.net/


Serial amnioinfusion to treat very early premature rupture of membranes 

Luis Díaz Guerrero, MD, Gelsy Giugni Chalbaud MD, A Sosa Olavarría, MD, PhD

Perinatology Unit, Maternidad Privada Las Acacias, Valencia, Venezuela

This 16-year-old primigravida presents at 16 weeks. She is referred for severe oligoamnios due to premature rupture of membranes. She was tested for hematologic markers of infection as well as culture of vaginal secretions and urine. At 19 weeks we perform an amniocentesis for fetal karyotyping and amnioinfusion. The infused liquid was lost in one week so we decided to perform weekly serial infusion amniocentesis. The growth, fetal anatomy and Doppler indices remain normal. Fetal karyotype was 46XX normal.

17 weeks, severe oligoamnios with no spontaneous recovery in spite of normal fetal urine production
After amniocentesis the membranes is visible in the liquid
The fetus avidly swallowed the liquid after each infusion
25 weeks, after amnioinfusion
29  weeks, after  amnioinfusion, normal fetal growth
Tissular Doppler: normal heart walls perfusion
Normal peripheric pulmonary arteries and veins: compatible with normal lungs circulation
Normal umbilical artery and vein Doppler
Normal Ductus Venosus Doppler wave

Respiratory movements at 30 weeks

 

Preterm labor occurred at 32 weeks with delivery of a baby girl, weighing 1756 gr in excellent conditions. She did not require respiratory support, and had no stigma of Potter Sequence.
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