Prophylactic amnioinfusion as a treatment for oligohydramnios in laboring patients: A prospective, randomized trial David B. Schrimmer, MD, Charles J. Macri, MD, and Richard H. Paul, MD Los Angeles, California Prophylactic amnioinfusion was studied in a randomized sample of 305 patients with oligohydramnios in labor. One hundred seventy-five patients underwent amnioinfusion with the remainder serving as controls. Amniotic fluid was titrated to an amniotic fluid index >10.0 cm in the treatment group. Patients receiving amnioinfusion had significantly less operative intervention for fetal distress (p = 0.0001) and fewer cesarean sections (p = 0.0001). Umbilical artery pH at the time of delivery also was increased (p = 0.0001). Rates of amnionitis and endometritis were not significantly different between infused patients and controls, although the length of hospital stay was significantly decreased (p = 0.002) in the treatment group. Our data support earlier reports in the literature that amnioinfusion is a useful technique for decreasing intrapartum morbidity for both mother and fetus. (AM J OBSTET GVNECOL 1991 ;165:972-5.)
Key words: Amnioinfusion, amniotic fluid index, operative intervention, fetal distress Amnioinfusion is being used for several indications, including prophylactic treatment of oligohydramnios, elimination of significant variable decelerations in labor, j., and· the prevention of meconium aspiration in laboring patients with thick meconium" Initial studies in the literature have been promising, with decreased operative intervention for fetal distress and improved neonatal outcome reported. 5 These findings are believed to be due to the restored cushioning effect of amniotic fluid and the subsequent prevention of cord compression. These initial studies, however, have raised questions about the use of amnioinfusion in statistically reducing the incidence of cesarean section for fetal distress and the relationship between amnioinfusion and intrapartum or postpartum infection. 5 , 6 The purpose of this study was to examine the effect of prophylactic amnioinfusion on the incidence of operative intervention for fetal distress, the fetal outcome, and its effect on the incidence of intrapartum and postpartum infection.
Material and methods Between Aug. 1, 1989, and Sept. 15, 1990, 305 patients at Los Angeles County/University of Southern California Women's Hospital were studied in a prospective, randomized fashion. Patients were initially identified as having oligohydramnios on admission on the basis of a four-quadrant amniotic fluid index of
Key words: Amnioinfusion, amniotic fluid index, operative intervention, fetal distress Amnioinfusion is being used for several indications, including prophylactic treatment of oligohydramnios, elimination of significant variable decelerations in labor, j., and· the prevention of meconium aspiration in laboring patients with thick meconium" Initial studies in the literature have been promising, with decreased operative intervention for fetal distress and improved neonatal outcome reported. 5 These findings are believed to be due to the restored cushioning effect of amniotic fluid and the subsequent prevention of cord compression. These initial studies, however, have raised questions about the use of amnioinfusion in statistically reducing the incidence of cesarean section for fetal distress and the relationship between amnioinfusion and intrapartum or postpartum infection. 5 , 6 The purpose of this study was to examine the effect of prophylactic amnioinfusion on the incidence of operative intervention for fetal distress, the fetal outcome, and its effect on the incidence of intrapartum and postpartum infection.
Material and methods Between Aug. 1, 1989, and Sept. 15, 1990, 305 patients at Los Angeles County/University of Southern California Women's Hospital were studied in a prospective, randomized fashion. Patients were initially identified as having oligohydramnios on admission on the basis of a four-quadrant amniotic fluid index of
