Intrapartum Amnioinfusion Research Articles

Intrapartum Amnioinfusion for Recurrent Variable Decelerations and Neonatal Morbidity: A Systematic Review and Meta-Analysis

Intrapartum Amnioinfusion for Recurrent Variable Decelerations and Neonatal Morbidity: A Systematic Review and Meta-Analysis

Role of intrapartum amnioinfusion in meconium-stained amniotic fluid

Background: Intrapartum amnioinfusion in meconium-stained amniotic fluid has been known to dilute the meconium and prevent meconium aspiration syndrome (MAS). However, the literature available on intrapartum amnioinfusion is varying. Objective: To assess the neonatal outcomes following intrapartum transcervical amnioinfusion in full-term pregnant women. Methods: This case-control study included pregnant women in active labor, divided into case group (n=63) receiving amnioinfusion and control group (n=63) without amnioinfusion. In the case group, 500 mL of warm, normal saline was infused into the uterine cavity. Both groups were compared for liquor quality, mode of delivery, and neonatal outcomes like APGAR score, resuscitation, meconium presence, MAS, neonatal intensive care unit (NICU) admission, and length of NICU stay. Chi-square test was used to analyze the difference between cases and controls. Results: Mode of delivery was spontaneous vaginal delivery in most cases (71%), with only 19% undergoing cesarean section. APGAR score at 1 min was >7 in cases compared to controls, which was significant (12.69% vs 0%, P=0.005). Resuscitation was required less in cases than controls (9.52% vs 50.79%, P<0.001). Presence of meconium below the vocal cord was more in controls (34.92% vs 4.76%, P=0.003). MAS was observed more in controls (26.98% vs 4.76%, P<0.001)

ROLE OF INTRAPARTUM AMNIOINFUSION IN MECONIUM STAINED LIQUOR.

Incidence of mecoium stained amniotic Fluid ranges from 7-22% and is an alarming sign of fetal compromise. It is associated with poor perinatal outcome. Intrapartum amnioinfusion has been a method to reduce the risk of mecoium aspiration. Aims and Objectives: To determine the fetal outcome in meconium stained liquor. Material and methods: This is a Prospective Case Control Study which was conducted in Department of Obstetrics and Gynaecology, National Institute of Medical Sciences and Research, Jaipur in the study period of 18 months. A total of 242 patients were included in the study and Were randomly divided into 2 groups and were compared for fetal outcome. Results: Amnioinfusion group(study group) had higher incidence of vaginal delivery and better neonatal outcome. Conclusion: Intrapartum amnioinfusion decreases rate of caesarean section and meconium aspiration syndrome.

What are the indications for intrapartum amnioinfusion?

What are the indications for intrapartum amnioinfusion?

Intrapartum Amnioinfusion in Meconium–stained Amniotic fluid: A Case Control study

Objective- The Aim of this study is to investigate Perinatal outcome and the rate of ceserean section following intrapartam amnioinfusion in women with Meconium Stained Amniotic Fluid (MASF). Method- A total of 100 women at term in labour with meconium stained amniotic fluid were randomised to receive either Transcervical Intrapartum Amnioinfusion with normal saline (50) or routine obstetric care (50). Perinatal outcome and obstetric outcome were recorded and analysed in both groups. Result- The ceserean section rate due to fetal distress was 34% in the control group and 10% in the study group. Respiratory distress of the neonate was significantly less common in the study group than in the control group (p=0.0053). The rate of Meconium Aspiration Syndrome (MAS) was 20% in the control group and 4% in the study study group.(p=0.0433). Conclusion- Amniotransfusion in cases of MSAF significantly improved neonatal outcome and decreases the

Intrapartum Amnioinfusion in Meconium-Stained Liquor: A Case–Control Study

The aim of this study was to investigate perinatal outcome and the rate of cesarean section (CS) following intrapartum amnioinfusion in women with meconium-stained amniotic fluid (MSAF). A total of 100 women at term in labor with meconium were randomized to infuse transcervical intrapartum amnioinfusion with saline (50) and routine obstetrical care (50). Perinatal outcome and obstetric outcome were recorded and analyzed in both groups by means of Chi-square test. The CS rate due to fetal distress was 40.0% in the control group and 20.0% in the study group. The difference was statistically significant (P<0.01). Respiratory distress of the neonate was significantly less common in the study group than in the control group (4.0% vs. 12%; P=0.0349). Amnioinfusion in cases of meconium-stained liquor significantly improved neonatal outcome and CS rate without increasing any maternal and fetal complications.

Role of Intrapartum Transcervical Amnioinfusion in Patients with Meconium-Stained Amniotic Fluid

The study was undertaken to evaluate maternal, perinatal outcomes following transcervical intrapartum amnioinfusion in women with meconium-stained amniotic fluid. A prospective comparative study was conducted on 100 women with meconium-stained amniotic fluid in labor. Group A: study group (50 cases) received amnioinfusion. Group B: control group (50 cases) did not receive amnioinfusion. FHR monitoring was done using cardiotocography. Significant relief from variable decelerations was seen in 68.18% cases in the amnioinfusion group as compared to 7.1% cases in the control group. 78% cases who were given amnioinfusion had vaginal delivery as compared to 18% cases in the control group. Fourteen percent cases in the study group had cesarean delivery as compared to 68% cases in the control group. Meconium aspiration syndrome was seen in six percent neonates in the study group as compared to 20% in the control group. Two neonates died in the control group due to meconium aspiration syndrome. There was no maternal mortality or major maternal complication. Intrapartum transcervical amnioinfusion is valuable in patients with meconium-stained amniotic fluid.

Intrauterine temperature during intrapartum amnioinfusion: a prospective observational study

To determine the influence of routine intrapartum amnioinfusion (AI) on intrauterine temperature. Prospective observational study. Maternity unit, Barnes Jewish Hospital, St Louis, MO, USA. Forty women with singleton gestations and an indication for intrapartum intrauterine pressure catheter placement. Using a temperature probe, we digitally recorded intrauterine temperature every 10 minutes during labour. Amnioinfusion was administered according to a standard protocol using saline equilibrated to the ambient temperature. Mean intrauterine temperature during labour. Participants were monitored for a mean of 280 minutes (range 20-820). A total of 164 intrauterine temperature readings in the AI cohort were compared with 797 control measurements. When compared with controls, we observed a lower intrauterine temperature in the AI cohort (36.4 versus 37.4°C, P<0.01). More measurements in the AI cohort were recorded in the presence of intrapartum fever (40% versus 30%). A subgroup analysis of measurements recorded in afebrile parturients revealed an even greater effect of AI (1.5°C decrease, 37.3 versus 35.8°C, P<0.01). Routine intrapartum AI using saline equilibrated to a mean ambient temperature of 25.0°C reduces intrauterine temperature and may thereby affect fetal core temperature.

The intrauterine temperature decreases during intrapartum amnioinfusion

The intrauterine temperature decreases during intrapartum amnioinfusion

430: The intrauterine temperature decreases during intrapartum amnioinfusion

An increase in fetal brain temperature of only 1°C may worsen hypoxic-ischemic encephalopathy (HIE). Akin to the effect of postnatal hypothermia, we surmised that cooling of the intrauterine environment may provide protection for fetuses at increased risk of HIE. We hypothesized that intrapartum amnioinfusion (AI) influences intrauterine temperature (IT).

Intrapartum amnioinfusion for meconium‐stained amniotic fluid: evidence for small study effect bias?

Intrapartum amnioinfusion for meconium‐stained amniotic fluid: evidence for small study effect bias?

Prophylactic Intrapartum Transcervical Amnioinfusion

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.

Intrapartum amnioinfusion for meconium‐stained amniotic fluid: a systematic review of randomised controlled trials

Intrapartum amnioinfusion for meconium‐stained amniotic fluid: a systematic review of randomised controlled trials

Intrapartum amnioinfusion for meconium‐stained amniotic fluid: a systematic review of randomised controlled trials

Intrapartum amnioinfusion for meconium‐stained amniotic fluid: a systematic review of randomised controlled trials

Authors response to: Intrapartum amnioinfusion for meconium‐stained amniotic fluid: a systematic review of randomised controlled trials

Authors response to: Intrapartum amnioinfusion for meconium‐stained amniotic fluid: a systematic review of randomised controlled trials

Intrapartum amnioinfusion for meconium‐stained amniotic fluid: a systematic review of randomised controlled trials

BJOG: An International Journal of Obstetrics & GynaecologyVolume 114, Issue 12 p. 1582-1583 Intrapartum amnioinfusion for meconium-stained amniotic fluid: a systematic review of randomised controlled trials N Jana, N Jana Department of Obstetrics and Gynaecology, Institute of Postgraduate Medical Education and Research, Kolkata, IndiaSearch for more papers by this authorS Barik, S Barik Department of Obstetrics and Gynaecology, Westbank Hospital, Howrah, IndiaSearch for more papers by this authorN Arora, N Arora Department of Obstetrics and Gynaecology, Institute of Postgraduate Medical Education and Research, Kolkata, IndiaSearch for more papers by this author N Jana, N Jana Department of Obstetrics and Gynaecology, Institute of Postgraduate Medical Education and Research, Kolkata, IndiaSearch for more papers by this authorS Barik, S Barik Department of Obstetrics and Gynaecology, Westbank Hospital, Howrah, IndiaSearch for more papers by this authorN Arora, N Arora Department of Obstetrics and Gynaecology, Institute of Postgraduate Medical Education and Research, Kolkata, IndiaSearch for more papers by this author First published: 08 November 2007 https://doi.org/10.1111/j.1471-0528.2007.01536.xCitations: 2Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article.Citing Literature Volume114, Issue12December 2007Pages 1582-1583 RelatedInformation

Intrapartum amnioinfusion for meconium‐stained amniotic fluid: a systematic review of randomised controlled trials

Amnioinfusion (AI) is thought to dilute meconium when present in the amniotic fluid and so reduces the risk of meconium aspiration. To evaluate if AI reduces meconium aspiration syndrome (MAS) and other indicators of morbidity in babies born to women with meconium-stained amniotic fluid (MSAF). PubMed, Medline, EMBASE, and the Cochrane Controlled Trials Register from January 1980 to May 30, 2005, using the keywords 'amnioinfusion' and 'meconium'. Randomised trials comparing AI with no AI for women in labour with MSAF. Trial quality was evaluated using pre-established criteria. The following morbidity indicators were assessed: MAS, 5-minute Apgar score < 7, arterial cord pH < 7.2, and caesarean section. Studies were stratified according to the level of peripartum surveillance (standard versus limited). Typical relative risks (RRs) with their 95% confidence intervals were calculated for each outcome using a random effects model. In clinical settings with standard peripartum surveillance, we found no evidence that AI reduced the risk of MAS (RR 0.59, 95% CI 0.28-1.25), 5-minute Apgar score < 7 (RR 0.90, 95% CI 0.58-1.41), or caesarean delivery (RR 0.89, 95% CI 0.73-1.10). In clinical settings with limited peripartum surveillance, AI appeared to reduce the risk of MAS (RR 0.25, 95% CI 0.13-0.47). In clinical settings with standard peripartum surveillance, the evidence does not support the use of AI for MSAF. In settings with limited peripartum surveillance, where complications of MSAF are common, AI appears to reduce the risk of MAS. However, this finding requires confirmation by further studies.

Antepartum amnioinfusion: a review

Objective: Antepartum amnioinfusion is a relatively recent procedure introduced with fetal medicine techniques. It is usually indicated for severe oligohydramnios in order to avoid the related complications such as pulmonary hypoplasia, the deforming effects of oligohydramnios, variable fetal heart rate decelerations and intraventricular hemorrhage. Antepartum amnioinfusion is also employed to improve ultrasound visualization in cases with oligohydramnios. Our objective was to evaluate the benefits and complications related to this procedure which is still less commonly used compared to intrapartum amnioinfusion, and whose risks are therefore not well established. Study design: Reports of study designs identified from searches of MEDLINE, PUBMED, the Cochrane Collaboration, specialized databases and bibliographies of review articles were identified. Studies in women who underwent amnioinfusion between 1987 and 2002 were included. Results and conclusions: Amnioinfusion seems to offer several benefits, in terms of both prenatal diagnosis and favorable perinatal outcome. Most clinical experiences report that amnioinfusion is safe, both for the mother and for the fetus. However, randomized control-group studies subdivided on the basis of the cause of oligohydramnios (e.g. premature rupture of membranes, fetal growth restriction, obstructive uropathy and renal agenesis) could help to determine the advantages and risks linked to this procedure. Prospective randomized studies should therefore be encouraged, to clarify any possible doubts regarding the procedure, before it can be introduced into routine practice in the management of oligohydramnios.

Prophylactic transcervical amnioinfusion in laboring women with oligohydramnios

Objectives: Evaluation of prophylactic intrapartum amnioinfusion in women with oligohydramnios. Methods: Assiut University Hospital during the period from February 2000 to September 2001, 160 laboring women with oligohydramnios [amniotic fluid index (AFI) ≤5 cm] were randomized into: amnioinfusion and control groups. Inclusion criteria were: term singleton gestation, vertex presentation, cervical dilatation <4 cm, and assuring fetal heart rate (FHR). Trans-cervical amnioinfusion was done with warmed normal saline. Results: there was a significant increase in AFI after amnioinfusion ( P<0.001). The amnioinfusion group showed lower cesarean section rate for fetal distress ( P=0.003), lower incidence of abnormal FHR ( P=0.006), fewer neonates with Apgar score <7 at 1 min ( P<0.001), and 5 min ( P=0.009), meconium below vocal cords ( P<0.001), umbilical arterial pH<7.1 ( P=0.003), and significantly shorter hospital stay ( P=0.02). Conclusion: Prophylactic trans-cervical amnioinfusion is a simple, safe and effective procedure.

Antepartum amnioinfusion: a review

Objective: Antepartum amnioinfusion is a relatively recent procedure introduced with fetal medicine techniques. It is usually indicated for severe oligohydramnios in order to avoid the related complicationssuch as pulmonary hypoplasia, the deforming effects of oligohydramnios, variable fetal heart rate decelerations and intraventricular hemorrhage. Antepartum amnioinfusion is also employed to improve ultrasoundvisualization in cases with oligohydramnios. Our objective was to evaluate the benefits and complications related to this procedure which is still less commonly used compared to intrapartum amnioinfusion,and whose risks are therefore not well established.Study design: Reports of study designs identified from searches of MEDLINE, PUBMED, the Cochrane Collaboration, specialized databases and bibliographiesof review articles were identified. Studies in women who underwent amnioinfusion between 1987 and 2002 were included.Results and conclusions: Amnioinfusion seems to offer several benefits, interms of both prenatal diagnosis and favorable perinatal outcome. Most clinical experiences report that amnioinfusion is safe, both for the mother and for the fetus. However, randomized control-group studiessubdivided on the basis of the cause of oligohydramnios (e.g. premature rupture of membranes, fetal growth restriction, obstructive uropathy and renal agenesis) could help to determine the advantages andrisks linked to this procedure. Prospective randomized studies should therefore be encouraged, to clarify any possible doubts regarding the procedure, before it can be introduced into routine practice inthe management of oligohydramnios.