A 30-year-old primigravida was admitted to hospital at 20 weeks of gestation because of premature
rupture of membranes and
oligohydramnios. The patient was maintained in
bed rest and given intravenous
ampicillin. Forty-eight hours later, after documenting the absence of
infection and maintenance of the
oligohydramnios,
fibrin glue was applied transcervically under ultrasound control. There was subjective improvement in amniotic fluid volume
after treatment, but always within the criteria of
oligohydramnios.
Fibrin glue application was repeated twice due to reported increase in fluid loss and diminished amniotic fluid volume on ultrasound.
Amoxicillin per os was started at 23 weeks, and
clavulanic acid was added at 26 weeks due to the isolation of an Escherichia coli on cervical-vaginal cultures. No signs of
infection ensued until 34 weeks, when an axillary temperature of 39.5 degrees C was detected together with a non-reassuring cardiotocographic pattern, the latter leading to the performance of an urgent
cesarean section. The newborn had an Apgar score of 9/10/10, umbilical artery pH of 7.32, and no external
deformities. He showed no signs of lung hypoplasia and required no
oxygen supplementation. Oropharyngeal and blood cultures revealed an E. coli
infection and
antibiotic treatment was started. No further complications occurred and he was discharged home on the 8th day of life. At 12 months, the child reveals a normal development. The mother had a mild and short-lasting
wound infection and was discharged on the 8th postoperative day.