Abstract
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.
Original language | English |
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Pages (from-to) | 292-301 |
Number of pages | 10 |
Journal | BJOG: An International Journal of Obstetrics and Gynaecology |
Volume | 128 |
Issue number | 2 |
Early online date | 4 Mar 2020 |
DOIs | |
Publication status | Published - 3 Jan 2021 |
Event | 38th Annual Meeting of the Society of Maternal Fetal Medicine - Las Vegas, United States Duration: 11 Feb 2019 → 16 Feb 2019 |
Bibliographical note
Presentation: Presented as a poster at the 38th Annual Meeting of the Society of Maternal Fetal Medicine, 11–16 February 2019, Las Vegas, Nevada, USALinked article This article is commented on by DW Skupski, p. 302 in this issue. To view this mini commentary visit https://doi.org/10.1111/1471-0528.16187.
Keywords
- Follow up
- infant development
- neurodevelopment
- oligohydramnios
- second-trimester prelabour rupture of the membranes