Amniopatch, a repairing technique for premature rupture of amniotic membranes in second trimester.

Abstract

Rupture of the amniotic sac complicates approximately 0.8-1% of amniocentesis procedures carried out between the 15th and 18th gestational weeks. Spontaneous PROM during the second and third trimester is, however, more frequent. In both cases the rate of fetal morbidity and mortality are very high. Infusion of an autolologous platelet concentrate followed by cryoprecipitates (amniopatch) restore the amnio-corial link interrupted by the iatrogenic trauma, thus making the amniotic repair processes even more effective. Five cases of premature membrane rupture in pregnancies ranging from 17 to 23 weeks have been treated with complete closure of the rupture and restoration of a normal amount of amniotic fluid in two cases and incomplete in the other three cases. Neonatal outcome, in accordance to the gestational stage reached by the patient, was good in three cases (41,32 and 27 weeks), complicated by brain hemorrage in the fourth and an abortion in fifth case. Amniopatch is able to physiologically facilitate this process and significantly prolong the pregnancy, improving neonatal outcome.