Pregnancy Outcome After Genetic Amniocentesis Complicated by Ruptured Membranes
December 1, 2000 2 minutes read
Pregnancy Outcome After Genetic Amniocentesis Complicated by Ruptured Membranes
ABSTRACT & COMMENTARY
Synopsis: Pregnancies complicated by PPROM after genetic amniocentesis result in significantly better outcomes than pregnancies complicated by spontaneous PPROM.
Source: Borgida AF, et al. Am J Obstet Gynecol 2000;183:937-939.
To determine the perinatal outcome of pregnancies complicated by preterm premature rupture of the membranes (PPROM) after genetic amniocentesis, these researchers evaluated 11 women who presented within 48 hours after the procedure with PPROM. They compared this group to 11 women who presented with spontaneous PPROM at 17-18 weeks. Women with PPROM after amniocentesis had a significantly longer latency period, 124 days, as compared to women with spontaneous PPROM, 28 days, and delivered at a more advanced gestational age, 34.2 weeks vs. 21.6 weeks. Women were followed with weekly ultrasound examinations and an average of 24 days was required for normal amniotic fluid volume to be restored (range, 8-51 days). Only one perinatal loss occurred in the 11 women with PPROM after genetic amniocentesis, a fetal death associated with chorioamnionitis at 19 weeks, while there was only one surviving infant in the group of 11 women with spontaneous PPROM.
Borgida and colleagues concluded that pregnancies complicated by PPROM after genetic amniocentesis result in significantly better outcomes than pregnancies complicated by spontaneous PPROM.
Comment by Steven G. Gabbe, MD
Complications after genetic amniocentesis include PPROM, bleeding, infection, miscarriage, and fetal injury. Fortunately, these are extremely rare. Few studies have examined the likelihood of PPROM after genetic amniocentesis in a large population from a single institution. The observation by Borgida et al that only 1% of patients experience leaking of fluid after genetic amniocentesis confirms smaller studies and is reassuring. In this setting, patients are usually advised to maintain pelvic rest, monitor their temperature, and return for periodic ultrasound examinations. In this study, overall pregnancy outcome was excellent in women with PPROM after genetic amniocentesis. Most patients delivered near term, and there was only one perinatal loss. Not surprisingly, perinatal outcome in a control group of patients with spontaneous PPROM was poor, with only one surviving infant in 11 pregnancies.
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