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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.


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.

SUBMITTER: de Ruigh AA 

PROVIDER: S-EPMC7818451 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Publications

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.

de Ruigh A A AA   Simons N E NE   van 't Hooft J J   van Teeffelen A S AS   Duijnhoven R G RG   van Wassenaer-Leemhuis A G AG   Aarnoudse-Moens C C   van de Beek C C   Oepkes D D   Haak M C MC   Woiski M M   Porath M M MM   Derks J B JB   van Kempen Lem L   Roseboom T J TJ   Mol B W BW   Pajkrt E E  

BJOG : an international journal of obstetrics and gynaecology 20200304 2


<h4>Objective</h4>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<sup>+0/7</sup> -24<sup>+0/7</sup>  weeks) and oligohydramnios.<h4>Population</h4>Follow up of infants of women who participated in the randomised controlled trial: PPROMEXIL-III (NTR3492).<h4>Methods</h4>Surviving infants were invited for neurodevelopmental assessment up to 5 years of corrected  ...[more]

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