Case Report: Respiratory outcome in a preterm infant following previable rupture of membranes and persistent oligohydramnios
Mid-trimester preterm premature rupture of membranes is a rare complication of pregnancy associated with significant maternal and fetal risks. The ensuing prolonged oligohydramnios can lead to fetal pulmonary hypoplasia. In addition, there is an increased risk of miscarriage, preterm birth, and chor...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2024.1457129/full |
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| author | Akila Subramanian Ong Kai Zhi Arun Kumar Pugalenthi Arun Kumar Pugalenthi Arun Kumar Pugalenthi Arun Kumar Pugalenthi Victor Samuel Rajadurai Victor Samuel Rajadurai Victor Samuel Rajadurai Victor Samuel Rajadurai Lay Kok Tan Suresh Chandran Suresh Chandran Suresh Chandran Suresh Chandran |
| author_facet | Akila Subramanian Ong Kai Zhi Arun Kumar Pugalenthi Arun Kumar Pugalenthi Arun Kumar Pugalenthi Arun Kumar Pugalenthi Victor Samuel Rajadurai Victor Samuel Rajadurai Victor Samuel Rajadurai Victor Samuel Rajadurai Lay Kok Tan Suresh Chandran Suresh Chandran Suresh Chandran Suresh Chandran |
| author_sort | Akila Subramanian |
| collection | DOAJ |
| description | Mid-trimester preterm premature rupture of membranes is a rare complication of pregnancy associated with significant maternal and fetal risks. The ensuing prolonged oligohydramnios can lead to fetal pulmonary hypoplasia. In addition, there is an increased risk of miscarriage, preterm birth, and chorioamnionitis, contributing to septic morbidity in the mother–baby dyad. This case report describes the management and outcomes of an infant born at 32 weeks following the rupture of membranes at 16 weeks of gestation, resulting in severe oligohydramnios. Soon after birth, the infant had respiratory compromise, requiring high-frequency oscillatory ventilation and nitric oxide. Despite the initial poor prognosis, the infant remained stable with various ventilation modalities managed by a multidisciplinary team. He was discharged home after 108 days in the hospital and remained on non-invasive ventilatory support until 8 months of age while the home care and hospital specialty teams monitored him. The favorable respiratory outcome of this case is a rarity for cases with similar clinical circumstances, in which the managing team counsels parents about poor fetal outcomes and many proceed to terminate the pregnancies. In this reported case, we highlight the importance of multidisciplinary and interprofessional team management from antepartum monitoring and planning delivery time to subsequent short- and long-term postnatal care involving maternal-fetal medicine specialists, neonatologists, pediatric cardiology and respiratory specialists, and home care teams. |
| format | Article |
| id | doaj-art-2d803a0934d745328486c757bad2c9cf |
| institution | Kabale University |
| issn | 2296-2360 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pediatrics |
| spelling | doaj-art-2d803a0934d745328486c757bad2c9cf2025-01-15T14:39:34ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-01-011210.3389/fped.2024.14571291457129Case Report: Respiratory outcome in a preterm infant following previable rupture of membranes and persistent oligohydramniosAkila Subramanian0Ong Kai Zhi1Arun Kumar Pugalenthi2Arun Kumar Pugalenthi3Arun Kumar Pugalenthi4Arun Kumar Pugalenthi5Victor Samuel Rajadurai6Victor Samuel Rajadurai7Victor Samuel Rajadurai8Victor Samuel Rajadurai9Lay Kok Tan10Suresh Chandran11Suresh Chandran12Suresh Chandran13Suresh Chandran14Department of Neonatology, KK Women’s and Children’s Hospital, Singapore, SingaporeDepartment of Maternal-Fetal Medicine, KK Women’s and Children’s Hospital, Singapore, SingaporeDepartment of Respiratory Medicine, KK Women’s and Children’s Hospital, Singapore, SingaporePediatric Academic Clinical Programme, Lee Kong Chian School of Medicine, Singapore, SingaporePediatric Academic Clinical Programme, Duke-NUS Medical School, Singapore, SingaporePediatric Academic Clinical Programme, Yong Loo Lin School of Medicine, Singapore, SingaporeDepartment of Neonatology, KK Women’s and Children’s Hospital, Singapore, SingaporePediatric Academic Clinical Programme, Lee Kong Chian School of Medicine, Singapore, SingaporePediatric Academic Clinical Programme, Duke-NUS Medical School, Singapore, SingaporePediatric Academic Clinical Programme, Yong Loo Lin School of Medicine, Singapore, SingaporeDepartment of Maternal-Fetal Medicine, KK Women’s and Children’s Hospital, Singapore, SingaporeDepartment of Neonatology, KK Women’s and Children’s Hospital, Singapore, SingaporePediatric Academic Clinical Programme, Lee Kong Chian School of Medicine, Singapore, SingaporePediatric Academic Clinical Programme, Duke-NUS Medical School, Singapore, SingaporePediatric Academic Clinical Programme, Yong Loo Lin School of Medicine, Singapore, SingaporeMid-trimester preterm premature rupture of membranes is a rare complication of pregnancy associated with significant maternal and fetal risks. The ensuing prolonged oligohydramnios can lead to fetal pulmonary hypoplasia. In addition, there is an increased risk of miscarriage, preterm birth, and chorioamnionitis, contributing to septic morbidity in the mother–baby dyad. This case report describes the management and outcomes of an infant born at 32 weeks following the rupture of membranes at 16 weeks of gestation, resulting in severe oligohydramnios. Soon after birth, the infant had respiratory compromise, requiring high-frequency oscillatory ventilation and nitric oxide. Despite the initial poor prognosis, the infant remained stable with various ventilation modalities managed by a multidisciplinary team. He was discharged home after 108 days in the hospital and remained on non-invasive ventilatory support until 8 months of age while the home care and hospital specialty teams monitored him. The favorable respiratory outcome of this case is a rarity for cases with similar clinical circumstances, in which the managing team counsels parents about poor fetal outcomes and many proceed to terminate the pregnancies. In this reported case, we highlight the importance of multidisciplinary and interprofessional team management from antepartum monitoring and planning delivery time to subsequent short- and long-term postnatal care involving maternal-fetal medicine specialists, neonatologists, pediatric cardiology and respiratory specialists, and home care teams.https://www.frontiersin.org/articles/10.3389/fped.2024.1457129/fullprematurityoligohydramniosprolonged rupture of membranespulmonary hypoplasiapersistent pulmonary hypertensionpulse oximetry study |
| spellingShingle | Akila Subramanian Ong Kai Zhi Arun Kumar Pugalenthi Arun Kumar Pugalenthi Arun Kumar Pugalenthi Arun Kumar Pugalenthi Victor Samuel Rajadurai Victor Samuel Rajadurai Victor Samuel Rajadurai Victor Samuel Rajadurai Lay Kok Tan Suresh Chandran Suresh Chandran Suresh Chandran Suresh Chandran Case Report: Respiratory outcome in a preterm infant following previable rupture of membranes and persistent oligohydramnios Frontiers in Pediatrics prematurity oligohydramnios prolonged rupture of membranes pulmonary hypoplasia persistent pulmonary hypertension pulse oximetry study |
| title | Case Report: Respiratory outcome in a preterm infant following previable rupture of membranes and persistent oligohydramnios |
| title_full | Case Report: Respiratory outcome in a preterm infant following previable rupture of membranes and persistent oligohydramnios |
| title_fullStr | Case Report: Respiratory outcome in a preterm infant following previable rupture of membranes and persistent oligohydramnios |
| title_full_unstemmed | Case Report: Respiratory outcome in a preterm infant following previable rupture of membranes and persistent oligohydramnios |
| title_short | Case Report: Respiratory outcome in a preterm infant following previable rupture of membranes and persistent oligohydramnios |
| title_sort | case report respiratory outcome in a preterm infant following previable rupture of membranes and persistent oligohydramnios |
| topic | prematurity oligohydramnios prolonged rupture of membranes pulmonary hypoplasia persistent pulmonary hypertension pulse oximetry study |
| url | https://www.frontiersin.org/articles/10.3389/fped.2024.1457129/full |
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