TY - JOUR
T1 - Interventional resealing of preterm premature rupture of the membranes
T2 - a systematic review and meta-analysis
AU - Ibirogba, Eniola R.
AU - Shazly, Sherif A.
AU - Narang, Kavita
AU - Wahood, Waseem
AU - Trad, Ayssa Teles Abrao
AU - Tsimis, Michael E.
AU - Ruano, Rodrigo
N1 - Publisher Copyright:
© 2021 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2022
Y1 - 2022
N2 - Objective: To compare the effectiveness and outcomes of interventional resealing of membranes, “amniopatch” for spontaneous vs. iatrogenic preterm premature rupture of the membranes (sPPROM and iPPROM). Methods: We performed a systematic review of literature involving an electronic search of the following databases: Ovid MEDLINE(R) and Epub Ahead of Print, In-Process and Other Non-Indexed Citations, Ovid MEDLINE(R) Daily, Ovid EMBASE, Ovid Cochrane Central Register of Controlled Trials, and Scopus. An indirect meta-analysis was then performed to compare the obstetric, maternal, fetal, and neonatal outcomes of amniopatch between the sPPROM and iPPROM groups. Results: The mean gestational age (GA) at the time rupture was 17.8 ± 1.8 and 25.2 ± 3.8 weeks for iPPROM and sPPROM, respectively, p =.005. Mean GA at the time of amniopatch procedure was 19.2 ± 2.07 weeks for iPPROM and 23 ± 3.1 weeks of gestation for sPPROM, p =.023. The rates of fluid re-accumulation (sPPROM 26% and iPPROM 53%, p =.09) were comparable between the sPPROM and iPPROM groups. Neonatal outcomes except for the rate of IUFD were also comparable between the groups. The incidence of IUFD was significantly higher in the iPPROM group (ES: 24%; 95% CI: 8.00–44.0%; p <.001), compared to sPPROM (ES: 0%; 95% CI: 0.00–4.00%). Obstetric and maternal outcomes were comparable between the two groups. Conclusions: Amniopatch appears to be a feasible and safe procedure for PPROM treatment. Further research is warranted to investigate the effectiveness of this procedure and establish a standardized criterion for the appropriate selection of patients that could benefit from this intervention.
AB - Objective: To compare the effectiveness and outcomes of interventional resealing of membranes, “amniopatch” for spontaneous vs. iatrogenic preterm premature rupture of the membranes (sPPROM and iPPROM). Methods: We performed a systematic review of literature involving an electronic search of the following databases: Ovid MEDLINE(R) and Epub Ahead of Print, In-Process and Other Non-Indexed Citations, Ovid MEDLINE(R) Daily, Ovid EMBASE, Ovid Cochrane Central Register of Controlled Trials, and Scopus. An indirect meta-analysis was then performed to compare the obstetric, maternal, fetal, and neonatal outcomes of amniopatch between the sPPROM and iPPROM groups. Results: The mean gestational age (GA) at the time rupture was 17.8 ± 1.8 and 25.2 ± 3.8 weeks for iPPROM and sPPROM, respectively, p =.005. Mean GA at the time of amniopatch procedure was 19.2 ± 2.07 weeks for iPPROM and 23 ± 3.1 weeks of gestation for sPPROM, p =.023. The rates of fluid re-accumulation (sPPROM 26% and iPPROM 53%, p =.09) were comparable between the sPPROM and iPPROM groups. Neonatal outcomes except for the rate of IUFD were also comparable between the groups. The incidence of IUFD was significantly higher in the iPPROM group (ES: 24%; 95% CI: 8.00–44.0%; p <.001), compared to sPPROM (ES: 0%; 95% CI: 0.00–4.00%). Obstetric and maternal outcomes were comparable between the two groups. Conclusions: Amniopatch appears to be a feasible and safe procedure for PPROM treatment. Further research is warranted to investigate the effectiveness of this procedure and establish a standardized criterion for the appropriate selection of patients that could benefit from this intervention.
KW - Fetal therapy
KW - amniopatch
KW - congenital anomalies
KW - prenatal diagnosis
KW - preterm premature rupture of the membranes
KW - ultrasound
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U2 - 10.1080/14767058.2021.1903858
DO - 10.1080/14767058.2021.1903858
M3 - Review article
C2 - 34392785
AN - SCOPUS:85111865860
SN - 1476-7058
VL - 35
SP - 5978
EP - 5992
JO - Journal of Maternal-Fetal and Neonatal Medicine
JF - Journal of Maternal-Fetal and Neonatal Medicine
IS - 25
ER -