Abstract
Fetal compression, pulmonary hypoplasia, and oligohydramnios have been previously associated with prolonged amniotic leak (PAL) syndrome. Eight fetuses were identified with PAL duration of 2 to 14 weeks. These fetuses were evaluated postnatally for pulmonary complications. In addition, prenatal real time ultrasound examination was utilized to measure the ratio of thoracic circumference to abdominal circumference (TC:AC). These neonates were beyond -1 S.D. of previously established mean values (normal mean ± SEM values of TC:AC = 0.944 ± 0.050). At birth there was evidence of oligohydramnios and compression; the mean ± SEM values were: birthweight, 1233 ± 110 gm; gestational age (GA), 29.1 ± 0.78 wks; onset of PAL, 22.6 ± 1.9 wks GA; duration of PAL, 6.5 ± 1.5 wks. Pulmonary hypertension, right to left shunting, severe respiratory acidosis and need for high peak inflation pressures (40 to 65 cm H2O) were observed in 5/8 neonates. Of these, 3 died and pulmonary hypoplasia was diagnosed at necropsy (mean lung weight 14.3 gm). Two of the survivors developed significant bronchopulmonary dysplasia. No long-term sequelae were observed in 3/8 neonates except the immediate need for ventilatory support. Both morbidity and mortality were best correlated to GA at onset of PAL and the GA at birth. These observations emphasize the need for intensive prenatal evaluation to predict fetal thoracic compression and postnatal pulmonary sequelae. Evidence of fetal thoracic compression may prove to be a useful determinant for optimal time of delivery with the PAL syndrome.
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Bhutani, V., Abbasi, S. & Weiner, S. PULMONARY SEQUELAE OF PROLONGED AMNIOTIC LEAK. Pediatr Res 18 (Suppl 4), 386 (1984). https://doi.org/10.1203/00006450-198404001-01757
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DOI: https://doi.org/10.1203/00006450-198404001-01757