Oligohydramnios Clinical Trial
Official title:
Open Randomized Trial Comparing Perinatal Outcome Following Expectant Management Versus Amnioinfusion in PPROM <25 Wks With Persistent Oligohydramnios
The aim of this study is to compare perinatal survival in patients presenting with early spontaneous PPROM and persistent oligohydramnios, managed either conservatively or with serial amnioinfusions.
Early spontaneous Preterm Premature Rupture of Membranes (PPROM) is associated with high
perinatal mortality. Due to pulmonary hypoplasia and preterm delivery, mortality exceeds 60%
when PPROM occurs prior to 24 weeks. When oligohydramnios persists, it may raise to 90%.
Morbidity in survivors is also significant. In uncontrolled series, serial amnioinfusions,
which have acceptable invasiveness and are of limited complexity, mortality was reduced to
60%.
We propose an open, multicenter randomized trial comparing perinatal survival in patients
presenting with early spontaneous PPROM and persistent oligohydramnios, managed either
conservatively or with serial amnioinfusions. Inclusion criteria: Single pregnancy, early
spontaneous PPROM < 24.3 weeks, oligohydramnios (deepest vertical pocket < 2 cm) for at
least 4 days and no longer than 15 days at enrolment. The study is open and will be run
through a dedicated password protected web site, and with a minimal number of outcome
measures. Primary outcome: Survival till discharge from the NICU. Secondary outcomes:
Latency time from PPROM to delivery, gestational age at birth, indication for delivery,
number of days of ventilatory support, serious neurologic morbidity, neonatal sepsis
prevalence, need for oxygen at 36 weeks post-conception.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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