Treatment of mid-trimester preterm premature rupture of membranes (PPROM) with multi-resistant bacteria-colonized anhydramnion with continuous amnioinfusion and meropenem: a case report and literature review
- PMID: 34791511
- PMCID: PMC8598399
- DOI: 10.1007/s00404-021-06319-w
Treatment of mid-trimester preterm premature rupture of membranes (PPROM) with multi-resistant bacteria-colonized anhydramnion with continuous amnioinfusion and meropenem: a case report and literature review
Abstract
Purpose: Treatment of mid-trimester classic preterm premature rupture of membranes (PPROM) with systemic antibiotics has limited success in the prevention of chorioamnionitis, funisitis and fetal inflammatory response syndrome because of very low transplacental passage.
Methods: Here we report a case of PPROM at 18 weeks gestation with anhydramnion colonized by multi-resistant Escherichia coli (E. coli). A catheter system was implanted at 23/2nd weeks gestation, enabling long-term continuous lavage of the amniotic cavity with Amnion Flush Solution (100 ml/h combined with intraamniotic meropenem application).
Results: The patient gave birth to a preterm male infant at 28/3rd without any signs of infection. In a follow-up examination at 24 months, there was no neurological disturbance or developmental delay.
Conclusion: The classic PPROM with multi-resistant E. coli colonization could be treated with continuous amnioinfusion and meropenem.
Keywords: 3-MRGN; Amnioinfusion; Anhydramnion; E. coli; PPROM; Preterm premature rupture of membranes.
© 2021. The Author(s).
Conflict of interest statement
None to declare.
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References
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- Berger R, Abele H, Bahlmann F, et al. Prävention und Therapie der Frühgeburt. Leitlinie der DGGG, OEGGG und SGGG (S2k-Niveau, AWMF-Registernummer 015/025, Februar 2019)—Teil 2 mit Empfehlungen zur tertiären Prävention der Frühgeburt und zum Management des frühen vorzeitigen Blasensprungs (Prevention and Therapy of Preterm Birth. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry Number 015/025, February 2019)—Part 2 with recommendations on the tertiary prevention of preterm birth and the management of preterm premature rupture of membranes) Z Geburtshilfe Neonatol. 2019;223:373–394. doi: 10.1055/a-1008-8730. - DOI - PubMed
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