Prophylactic Intrapartum Transcervical Amnioinfusion

Abstract

Infusion of sterile saline solution into the amniotic cavity has been used to increase the volume of intrauterine fluid or to dilute potentially damaging substances in the fluid. Regarding the route of administration, amnioinfusion can be done transabdominally or transcervically, and with regard to the timing of the procedure, it can be performed before labor or during labor. The present review updates our knowledge of transcervical intrapartum amnioinfusion. Although this therapeutic procedure is widely known and used, it is currently considered controversial for certain indications. Its use is disputed for gestations with oligohydramnios and ruptured or intact membranes to reduce potential umbilical cord compression, for labor with a preterm fetus and ruptured membranes, and for meconium-stained amniotic fluid to reduce complications that can arise from aspiration of fecal matter into the fetal tracheobronchial tree. An exhaustive analysis of the literature shows that the procedure is useful for reducing the rate of operative deliveries and ensuring appropriate metabolic status of the fetus upon delivery.