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CASE REPORT article

Front. Pediatr.
Sec. Neonatology
Volume 12 - 2024 | doi: 10.3389/fped.2024.1457129

Respiratory outcome in a preterm infant following previable rupture of membranes and persistent oligohydramnios: A Case Report

Provisionally accepted
Akila Subramanian Akila Subramanian 1*Kai Zhi Ong Kai Zhi Ong 2Arun Kumar Pugalenthi Arun Kumar Pugalenthi 2,3,4,5*Victor Samuel Rajadurai Victor Samuel Rajadurai 1,3,4,5Lay Kok Tan Lay Kok Tan 6*SURESH CHANDRAN SURESH CHANDRAN 1,3,4,5*
  • 1 Department of Neonatology, KK Women's and Children's Hospital, Singapore, Singapore
  • 2 KK Women's and Children's Hospital, Singapore, Singapore
  • 3 Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
  • 4 Singhealth Duke NUS Academic Medical Centre, Singapore, Singapore
  • 5 Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
  • 6 Department of Reproductive Medicine, KK Women’s and Children’s Hospital, Singapore, Singapore

The final, formatted version of the article will be published soon.

    Mid-trimester preterm premature rupture of membranes (PPROM) is a rare complication of pregnancy associated with significant maternal and fetal risks. The ensuing prolonged oligohydramnios can lead to fetal pulmonary hypoplasia. Additionally, there is an increased risk of miscarriage, preterm birth, and chorioamnionitis, contributing to septic morbidity in 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 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 of hospital stay and remained in non-invasive ventilatory support till 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 in similar clinical circumstances, where the managing team would counsel parents about poor fetal outcomes, and many would 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.

    Keywords: prematurity, Oligohydramnios, prolonged rupture of membranes, pulmonary hypoplasia, Persistent Pulmonary Hypertension, pulse oximetry study

    Received: 30 Jun 2024; Accepted: 18 Dec 2024.

    Copyright: © 2024 Subramanian, Ong, Pugalenthi, Rajadurai, Tan and CHANDRAN. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Akila Subramanian, Department of Neonatology, KK Women's and Children's Hospital, Singapore, 229899, Singapore
    Arun Kumar Pugalenthi, KK Women's and Children's Hospital, Singapore, Singapore
    Lay Kok Tan, Department of Reproductive Medicine, KK Women’s and Children’s Hospital, Singapore, Singapore
    SURESH CHANDRAN, Singhealth Duke NUS Academic Medical Centre, Singapore, 168753, Singapore

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