Abstract
Spontaneous rupture of membranes (SROM) in the second trimester of pregnancy is associated with an extremely poor prognosis in the infant, primarily due to pulmonary hypoplasia (PH) therefore parents are offered elective abortion. PH does not occur universally however, and some infants survive. In an attempt to predict in utero the development of PH, we examined by realtime ultrasonography the quality and quantity of fetal breathing movements (FBM) in 10 pregnancies complicated by oligohydramnios due to SROM at a mean gestation of 22 wks (range 15-26 wks). The groups were similar in onset (Group A mean 22 wks, range 18-26, Group B mean 22 wks, range 15-26) and duration of oligohydramnios (Group A 5 wks range 1-10, Group B 6 weeks range 1-19). Although all the infants in Group A had respiratory difficulties attributable to prematurity, they did not have PH and they all survived. In contrast in Group B, 1 patient elected to have a termination of pregnancy and postmortem of the fetus showed PH. Of the 4 patients who continued with their pregnancies, 1 had an IUD and 3 neonatal deaths, in 3 of these postmortems were performed and PH was present. These preliminary results suggest that the presence of FBM, when oligohydramnios complicates the second trimester of pregnancy, may be a useful predictor of continuing lung growth and development.
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Blott, M., Nicolaides, K. & Greenough, A. FETAL BREATHING MOVEMENTS, NOT AMNIOTIC FLUID VOLUME, PRESERVE ANTENATAL LUNG GROWTH. Pediatr Res 22, 228 (1987). https://doi.org/10.1203/00006450-198708000-00089
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DOI: https://doi.org/10.1203/00006450-198708000-00089