The Role of Prophylactic Intrapartum Amnioinfusion In Cases of Oligohydramnios (A Prospective Randomized Study)

Abstract

Amnioinfusion is a simple, safe, and beneficial procedure in laboring women with oligohydramnios. The current study was conducted to introduce amnioinfusion as a new service in Assuit University Hospital. It was designed to evaluate the role of prophylactic intrapartum amnioinfusion in laboring women with oligohydramnios (as the primary outcome). It was also aimed at evaluating the role of amnioinfusion in relation to different causes of oligohydramnios including post-date and rupture of membranes, and in relation to different parity with recoding of any complication (as secondary outcomes).

During the period from February 2000 to September 200 L laboring women with oligohydramnios (amniotic fluid index ::: 5 em) at Assuit University Hospital were evaluated for participation in a prospective randomized trial. Informed consents were obtained from 160 women randomized in:o 2 groups treatment and non-treatment (80 women in each). The inclusion criteria included term singleton gestation, vertex presentation, cervical dilatation < 4 em, with assuring fetal heart rate (FHR). Exclusion criteria included vaginal bleeding, known fetal anomalies, uterine scar, symmetrical growth retardation. fever, granmultipara ?: 5 times and estimated fetal weight ::: 1500 gm. Trans••

cervical amnioinfusion done in amnioinfusion group with total infusion of 1000 cc of warmed nonnal saline beginning by a bolus of 500 cc along 20-30 minutes followed by gravity drainage of the remaining 500 cc. Outcome parameter included FHR pattern assessment, number. of cesarean section due to fetal distress, Apgar score at land 5 minutes, umbilical artery pH, examination for meconium below vocal cords, and need for neonatal intensive care unit admission.