Child outcomes after amnioinfusion compared with no intervention in women with second-trimester rupture of membranes: a long-term follow-up study of the PROMEXIL-III trial.

Autor: de Ruigh AA; Department of Obstetrics and Gynaecology, Academic Medical Centre (AMC), Amsterdam, The Netherlands., Simons NE; Department of Obstetrics and Gynaecology, Academic Medical Centre (AMC), Amsterdam, The Netherlands., van 't Hooft J; Department of Obstetrics and Gynaecology, Academic Medical Centre (AMC), Amsterdam, The Netherlands., van Teeffelen AS; Department of Obstetrics and Gynaecology, Grow, School for Oncology and Developmental Biology, Maastricht University Medical Centre (MUMC), Maastricht, The Netherlands., Duijnhoven RG; Department of Obstetrics and Gynaecology, Academic Medical Centre (AMC), Amsterdam, The Netherlands., van Wassenaer-Leemhuis AG; Department of Neonatology, Emma Children's Hospital Academic Medical Centre (AMC), Amsterdam, The Netherlands., Aarnoudse-Moens C; Department of Neonatology, Emma Children's Hospital Academic Medical Centre (AMC), Amsterdam, The Netherlands., van de Beek C; Department of Obstetrics and Gynaecology, Amsterdam Reproduction and Development Research Institute, Academic Medical Centre (AMC), Amsterdam, The Netherlands., Oepkes D; Department of Obstetrics and Gynaecology, Leiden University Medical Centre (LUMC), Leiden, The Netherlands., Haak MC; Department of Obstetrics and Gynaecology, Leiden University Medical Centre (LUMC), Leiden, The Netherlands., Woiski M; Department of Obstetrics and Gynaecology, Radboud University Medical Centre (Radboudumc), Nijmegen, The Netherlands., Porath MM; Department of Obstetrics and Gynaecology, Maxima Medical Centre (MMC), Veldhoven, The Netherlands., Derks JB; Department of Obstetrics and Gynaecology, University Medical Centre Utrecht (UMCU), Utrecht, The Netherlands., van Kempen L; Department of Obstetrics and Gynaecology, Academic Medical Centre (AMC), Amsterdam, The Netherlands., Roseboom TJ; Department of Obstetrics and Gynaecology, Amsterdam Reproduction and Development Research Institute, Academic Medical Centre (AMC), Amsterdam, The Netherlands., Mol BW; Obstetrics and Gynaecology, Monash University, Melbourne, Victoria, Australia., Pajkrt E; Department of Obstetrics and Gynaecology, Academic Medical Centre (AMC), Amsterdam, The Netherlands.
Jazyk: angličtina
Zdroj: BJOG : an international journal of obstetrics and gynaecology [BJOG] 2021 Jan; Vol. 128 (2), pp. 292-301. Date of Electronic Publication: 2020 Mar 04.
DOI: 10.1111/1471-0528.16115
Abstrakt: Objective: To assess the effect of transabdominal amnioinfusion or no intervention on long-term outcomes in children born after second-trimester prelabour rupture of the membranes (PROM between 16 +0/7 -24 +0/7  weeks) and oligohydramnios.
Population: Follow up of infants of women who participated in the randomised controlled trial: PPROMEXIL-III (NTR3492).
Methods: Surviving infants were invited for neurodevelopmental assessment up to 5 years of corrected age using a Bayley Scales of Infant and Toddler Development or a Wechsler Preschool and Primary Scale of Intelligence. Parents were asked to complete several questionnaires.
Main Outcome Measures: Neurodevelopmental outcomes were measured. Mild delay was defined as -1 standard deviation (SD), severe delay as -2 SD. Healthy long-term survival was defined as survival without neurodevelopmental delay or respiratory problems.
Results: In the amnioinfusion group, 18/28 children (64%) died versus 21/28 (75%) in the no intervention group (relative risk 0.86; 95% confidence interval [CI] 0.60-1.22). Follow-up data were obtained from 14/17 (82%) children (10 amnioinfusion, 4 no intervention). In both groups, 2/28 (7.1%) had a mild neurodevelopmental delay. No severe delay was seen. Healthy long-term survival occurred in 5/28 children (17.9%) after amnioinfusion versus 2/28 (7.1%) after no intervention (odds ratio 2.50; 95% CI 0.53-11.83). When analysing data for all assessed survivors, 10/14 (71.4%) survived without mild neurodevelopmental delay and 7/14 (50%) were classified healthy long-term survivor.
Conclusions: In this small sample of women suffering second-trimester PROM and oligohydramnios, amnioinfusion did not improve long-term outcomes. Overall, 71% of survivors had no neurodevelopmental delay.
Tweetable Abstract: Healthy long-term survival was comparable for children born after second-trimester PROM and treatment with amnioinfusion or no intervention.
(© 2020 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists.)
Databáze: MEDLINE
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