Author + information
- Muxue Yu,
- Chuyi Guo,
- Xiaoyu Li,
- Zhentong Lu and
- Siqi Zhuang
To improve the recognition and management of oligohydramnios-induced lethal pulmonary hypoplasia (LPH) secondary to prelabor rupture of membranes (PROM).
We present a case of oligohydramnios-induced LPH secondary to PROM. Relevant literature was reviewed.
The male infant was born at 30+3 week's gestation by caesarean. Ultrasonic examination showed the amniotic fluid index (AFI) was 0 cm, the estimated fetal weight (EFW) was 1153 g, and the estimated fetal gestational age (GA) was 28+4 weeks. His mother hadamniotic fluid leak for 5 days and twin pregnancy. He developed cyanosis and lethargic after birth. Endotracheal intubation, positive pressure ventilation, chest compression were performed. He didn't show improvement and died at 2 hours after birth. Chest X-rays showed bell-shaped thorax, bilateral pneumothorax and pneumomediastinum. Ultrasonic examination of the other fetal showed the AFI was 63 cm, the EFW was 1443 g, and the estimated fetal GA was 29+6 weeks. The male infant developed cyanosis and lethargic after birth and showed improvement after endotracheal intubation. This case had a history of PROM, anhydramnios and inconsistent development in twins. The clinical and radiologic manifestations were corresponding to LPH diagnosis. According to literature of 144 cases of LPH secondary to midtrimester PROM, GA at PROM, latency period and AFI were predictors of LPH. It was hypothesized that dry lung syndrome might be functional pulmonary hypoplasia.
To prevent LPH, PROM management included AFI, fetal biometric indices and pulmonary vessels examination. Neonatal management might include volume-targeted, high-frequency ventilation and nitric oxide.