Amnioinfusion

Amnioinfusion is a method in which isotonic fluid is instilled into the uterine cavity.

Amnioinfusion
ICD-9-CM75.37

It is primarily used as a treatment in order to correct fetal heart rate changes caused by umbilical cord compression, indicated by variable decelerations seen on cardiotocography. In severe cases of oligohydramnios, amnioinfusion may be performed prophylactically to prevent umbilical cord compression.[1]

It has also been used to reduce the risk of meconium aspiration syndrome, though evidence of benefit is mixed.[2][3][4] The UK National Institute of Health and Clinical Excellence (NICE) Guidelines recommend against the use of amnioinfusion in women with meconium stained amniotic fluid (MSAF).[5]

Complications

Complications of amnioinfusion may include chorioamnionitis, umbilical cord prolapse, premature rupture of membranes, preterm labor, and prolongation of labor. . There are case reports of maternal amniotic fluid embolism, but a clear causal relationship has not been demonstrated.[6]

It is recommended that amnioinfusion be performed at centers specializing in fetal medicine and within the context of a multidisciplinary team.[7]

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References
  1. Hsu TL, Hsu TY, Tsai CC, Ou CY (December 2007). "The experience of amnioinfusion for oligohydramnios during the early second trimester". Taiwan J Obstet Gynecol. 46 (4): 395–8. doi:10.1016/S1028-4559(08)60009-1. PMID 18182345.
  2. Fraser WD, Hofmeyr J, Lede R, et al. (September 2005). "Amnioinfusion for the prevention of the meconium aspiration syndrome". N. Engl. J. Med. 353 (9): 909–17. doi:10.1056/NEJMoa050223. PMID 16135835.
  3. Edwards RK, Duff P (1999). "Prophylactic cefazolin in amnioinfusions administered for meconium-stained amniotic fluid". Infect Dis Obstet Gynecol. 7 (3): 153–7. doi:10.1155/S1064744999000241. PMC 1784731. PMID 10371474.
  4. Hofmeyr GJ, Xu H, Eke AC. Amnioinfusion for meconium-stained liquor in labour. Cochrane Database Syst Rev 2014; 1:CD000014.
  5. Stenson, Benjamin James; Smith, Claire Lindsay (December 2012). "Management of meconium aspiration syndrome". Paediatrics and Child Health. 22 (12): 532–535. doi:10.1016/j.paed.2012.08.015. ISSN 1751-7222.
  6. Roberts WE, Martin RW, Roach HH, et al. Are obstetric interventions such as cervical ripening, induction of labor, amnioinfusion, or amniotomy associated with umbilical cord prolapse? Am J Obstet Gynecol 1997; 176:1181.
  7. Oligohydramnios Archived 2016-09-20 at the Wayback Machine at the National Institute for Health and Clinical Excellence. Based on the overview Therapeutic amnioinfusion for oligohydramnios during pregnancy (excluding labour) Archived 2013-02-18 at the Wayback Machine in 2006


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