Pulmonary Hypoplasia is one of the Top 3 Concerns of PPROM, along with extreme premature birth and chorioamnionitis/sepsis. If is especially a factor for women who rupture before 24 weeks.
Without amniotic fluid available in the amniotic sac, the baby is unable to practice breathing and will not be able to grow lung tissue to sustain life outside the womb.
Here is what we know:
1. There is no way to accurately "see" lungs on ultrasound, MRI, X-Ray PRIOR to birth. Ultrasonographers can take measurements, see growth patterns and track fluid volume (if any) during the pregnancy.
2. If the baby is able to be ventilated at birth, aggressive management can help treat Pulmonary Hypoplasia (Surfactant, Nitric Oxide Treatment up to 40%, High Frequency Jet or Oscillating Ventilation, Steroids). Many babies require respiratory support once they are discharged home.
3. PPROM babies may be born with smaller lung capacity due to their low fluid. Given time and positive growth, they can grow healthy lung tissue outside of the womb. It is important to keep PPROM babies healthy and minimize environmental triggers that could affect their lung development.
4. Extremely premature birth can further complicate Pulmonary Hypoplasia. If a baby is unable to be ventilated, has an infection, or other complication, it can be fatal.
5. Babies with prolonged PPROM over 10 weeks, delivered past 30 weeks may have difficulty in the NICU with pulmonary issues, even if their complications due to prematurity have minimized. Because of the extra weeks in the womb, many of these babies have had time to grow physically while their lungs have been compromised due to PPROM. Time and growth are the best indicators of lung development in the NICU.
- Inhaled Nitric Oxide for Preterm Premature Rupture of Membranes, Oligohydramnios, and Pulmonary Hypoplasia
- Pediatric Pulmonary Hypoplasia from Medscape
Pediatric Pulmonary Hypoplasia from Medscape
Inhaled Nitric Oxide for Preterm Premature Rupture of Membranes, Oligohydramnios, and Pulmonary Hypoplasia
Treatment with inhaled nitric oxide is associated with improved survival in preterm neonates diagnosed with pulmonary hypoplasia
Contribution of Amniotic Fluid along Gestation to the Prediction of Perinatal Mortality in Women with Early Preterm Premature Rupture of Membranes