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Prophylactic versus therapeutic amnioinfusion for oligohydramnios in labourHofmeyr GJ
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SummaryProphylactic versus therapeutic amnioinfusion for ogliohydramnios in labourAmnioinfusion can help when a baby is surrounded by too little fluid in the womb (oligohydramnios) and is showing distress, but is not needed otherwise. Oligohydramnios is a condition where too little fluid surrounds the baby in the womb (uterus). Oligohydramnios does not seem to affect some babies, but others may show signs of distress, such as unusual heart rates or the passing of a bowel motion (meconium). Oligohydramnios can be relieved by injections of extra liquid (salt or ringers lactate solution) through the woman's vagina or abdomen into the womb (amnioinfusion). The review of trials found that amnioinfusion for oligohydramnios helps when the baby shows signs of distress. If the baby shows no signs of distress from oligohydramnios, then amnioinfusion is not helpful.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2009 Issue 2, Copyright © 2009 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
This version first published online:
April 25. 1995 AbstractBackgroundAmnioinfusion aims to relieve umbilical cord compression during labour by infusing a liquid into the uterine cavity. ObjectivesThe objective of this review was to assess the effects of prophylactic amnioinfusion for oligohydramnios compared with therapeutic amnioinfusion only if fetal heart rate decelerations or thick meconium-staining of the liquor occur. Search strategyThe Cochrane Pregnancy and Childbirth Group trials register and Cochrane Controlled Trials Register were searched. Date of last search: October 2001. Selection criteriaRandomised trials comparing prophylactic with therapeutic amnioinfusion in women with oligohydramnios but not fetal heart rate deceleration in labour. Data collection and analysisThe reviewer assessed trial quality and extracted data. Main resultsTwo studies of 285 women were included. No differences were found in the rate of caesarean section (relative risk 0.98, 95% confidence interval 0.58 to 1.66), or forceps delivery. There were no difference in Apgar scores, cord arterial pH, oxytocin augmentation, meconium aspiration, neonatal pneumonia or postpartum endometritis. Prophylactic amnioinfusion was associated with increased intrapartum fever (relative risk 3.48, 95% confidence interval 1.21 to 10.05). Authors' conclusionsThere appears to be no advantage of prophylactic amnioinfusion over therapeutic amnioinfusion carried out only when fetal heart rate decelerations or thick meconium-staining of the liquor occur. |