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Prophylactic versus therapeutic amnioinfusion for oligohydramnios in labour

Amnioinfusion 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 one trial, involving 116 women, 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.

研究背景

Amnioinfusion aims to relieve umbilical cord compression during labour by infusing a liquid into the uterine cavity.

研究目的

The objective of this review was to assess the effects of prophylactic amnioinfusion for women in labour with oligohydramnios, but not fetal heart deceleration, compared with therapeutic amnioinfusion only if fetal heart rate decelerations or thick meconium-staining of the liquor occur.

检索策略

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (28 February 2012).

纳入排除标准

Randomised trials comparing prophylactic amnioinfusion in women in labour with oligohydramnios but not fetal heart rate deceleration in labour with therapeutic amnioinfusion.

资料收集与分析

The authors assessed trial quality and extracted data.

主要结果

One randomized trial of 116 women was included. No differences were found in the rate of caesarean section (risk ratio 1.29, 95% confidence interval 0.60 to 2.74). There were no differences in cord arterial pH, oxytocin augmentation, neonatal pneumonia or postpartum endometritis. Prophylactic amnioinfusion was associated with increased intrapartum fever (risk ratio 3.48, 95% confidence interval 1.21 to 10.05).

作者结论

There 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.

引用文献
Novikova N, Hofmeyr GJ, Essilfie-Appiah G. Prophylactic versus therapeutic amnioinfusion for oligohydramnios in labour. Cochrane Database of Systematic Reviews 2021, Issue 8. Art. No.: CD000176. DOI: 10.1002/14651858.CD000176.pub2.

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