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Successful outcome following pre-viability amniorrhexis
Samuel Engemise1, Emmanuel Kalu, Khalid Haque
1Department of Obstetrics and Gynaecology, St Helier Hospital, Wrythe Lane, Carshalton, Surrey, SM5 1AA, UK. engemisesam@doctors.org.uk
Archives of Gynecology and Obstetrics
|January 16, 2007
Summary
This case study highlights a successful pregnancy outcome despite prolonged rupture of membranes (PROM) and anhydramnion before viability. It emphasizes the importance of parental support throughout the challenging neonatal period.
Area of Science:
- Reproductive Medicine
- Maternal-Fetal Medicine
- Neonatology
Background:
- Severe infertility due to bilateral tubal disease and endometriosis necessitated in vitro fertilization.
- A 34-year-old primigravida underwent multiple IVF attempts for conception.
Observation:
- Spontaneous rupture of membranes occurred at 17 weeks gestation in a high-risk pregnancy.
- The patient elected to continue the pregnancy despite anhydramnion and risks of prolonged rupture of membranes (PROM) before viability.
- Delivery at 28 weeks was required due to abruption placentae and antepartum hemorrhage.
Findings:
- A male infant weighing 1,100g was delivered via emergency cesarean section.
- The infant exhibited no signs of Potter's features, skeletal deformities, intrauterine growth restriction, or pulmonary hypoplasia, despite the severe PROM and anhydramnion.
- This case represents a rare successful outcome following prolonged pre-viability PROM.
Implications:
- Successful management of prolonged pre-viability PROM is possible, though rare.
- Extensive counseling and psychological support are crucial for parents facing such high-risk pregnancies and neonatal outcomes.
- This case contributes to the limited literature on managing extreme PROM and its impact on neonatal development.
