1. Treatment of Preterm Premature Rupture of Membranes with Oligo-/Anhydramnion Colonized by Multiresistant Bacteria with Continuous Amnioinfusion and Antibiotic Administrations through a Subcutaneously Implanted Intrauterine Port System: A Case Report.
- Author
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Tchirikov M, Zhumadilov Z, Winarno AS, Haase R, and Buchmann J
- Subjects
- Adult, Anti-Bacterial Agents administration & dosage, Anti-Bacterial Agents therapeutic use, Catheters, Indwelling adverse effects, Chorioamnionitis prevention & control, Combined Modality Therapy adverse effects, Drug Resistance, Multiple, Bacterial, Drug Therapy, Combination adverse effects, Female, Fetal Membranes, Premature Rupture microbiology, Humans, Infant, Newborn, Infusions, Intralesional, Kazakhstan, Klebsiella pneumoniae drug effects, Live Birth, Oligohydramnios microbiology, Oligohydramnios physiopathology, Pregnancy, Severity of Illness Index, Treatment Outcome, Amniotic Fluid microbiology, Antibiotic Prophylaxis adverse effects, Biological Therapy adverse effects, Fetal Membranes, Premature Rupture therapy, Klebsiella pneumoniae growth & development, Oligohydramnios therapy, Therapeutic Irrigation adverse effects
- Abstract
Bacterial infection is one of the main causes of preterm premature rupture of membranes (PPROM) leading to preterm delivery, pulmonary hypoplasia, sepsis and joint deformities. Expectant management, broad-spectrum antibiotics and antenatal corticosteroids are routinely used in this condition with very limited success to prevent bacteremia, chorioamnionitis, funisitis and intra-amniotic infection syndrome. Here, we report a case in which we attempted to treat PPROM at 26+3 weeks of gestation with anhydramnion colonized by multiresistant Klebsiella. A perinatal port system was implanted subcutaneously at 28+0 weeks of gestation, enabling long-term continuous lavage of the amniotic cavity with a hypotonic aqueous composition similar to human amniotic fluid combined with intra-amniotic antibiotic application. The patient gave birth to a preterm female infant at 31+1 weeks without any signs of infection. The girl was discharged with a weight of 2,730 g in very good condition. In the follow-up examinations at 5 months and 1 year of age, there was no apparent neurological disturbance, developmental delay or Klebsiella colonization., (© 2015 The Author(s) Published by S. Karger AG, Basel.)
- Published
- 2017
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