Amniopatch Procedure in Management of Preterm PROM at Single Tertiary Center Experience of Low Resource Setting in Indonesia: A Case Report

Preterm Premature Rupture of Membranes (PROM) remains a significant cause of preterm birth, contributing substantially to neonatal morbidity and mortality, particularly in low-resource settings. The amniopatch procedure has emerged as a potential therapy to restore amniotic fluid and prolong pregnancy. This study was conducted with aim of describing the institutional experience and clinical outcomes of amniopatch procedures performed for spontaneous preterm PROM. This case series reported three women with spontaneous preterm PROM between 26 and 31 weeks of gestation. Each underwent ultrasound-guided amniopatch using autologous thrombocyte concentrate (20-40 mL) and cryoprecipitate (20-40 mL). Maternal and fetal conditions were monitored through clinical and ultrasonographic assessments. Outcomes included changes in Amniotic Fluid Index (AFI), latency period, and neonatal survival. All patients experienced a post-procedure increase in AFI within 3 days (from 1.1-7.1 cm pre-procedure to 5.2-8.7 cm). The latency period extended from 5 to 16 days after amniopatch (8-20 days from PROM to delivery). No maternal complications or procedure-related infections were observed. Two of three neonates survived with normal growth at six months, while one neonate born at 28 weeks died from respiratory distress syndrome. Amniopatch may represent a feasible, low-cost adjunctive therapy for managing spontaneous preterm PROM in low-resource tertiary hospitals. It demonstrates potential to increase amniotic fluid, prolong gestation, and improve neonatal outcomes without maternal adverse effects. Larger comparative studies are needed to establish standardized protocols and assess long-term safety.