Spontaneous Membrane Resealing Following Preterm Premature Rupture of Membranes at 26 Weeks of Gestation: A Rare Case Report

Abstract

Objective: To report a case of preterm premature rupture of membranes (PPROM) at an early gestational age with spontaneous resealing of the amniotic membrane, and to discuss the clinical implications of this phenomenon. Methods: Case report with follow-up of clinical course, laboratory and ultrasound findings, and maternal–neonatal outcomes.Results: A 35-year-old primigravida at 25 weeks and 5 days of gestation was diagnosed with PPROM based on clinical findings and a positive Actim PROM test, accompanied by anhydramnios and early-onset fetal growth restriction (FGR). Following expectant management and inpatient monitoring, the leakage of amniotic fluid ceased completely, and the amniotic fluid volume returned to normal after 11 days, suggesting spontaneous membrane resealing. However, fetal growth restriction and progressive uteroplacental insufficiency developed, leading to cesarean delivery at 31 weeks and 2 days of gestation. The preterm neonate was born alive and received resuscitation and neonatal intensive care. Conclusion: Spontaneous resealing of the amniotic membranes after PPROM is an uncommon event. Restoration of amniotic fluid volume does not necessarily indicate recovery of placental function. Decisions regarding timing of delivery should be based on comprehensive fetal assessment.