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A substantive amendment to this systematic review was last made on 19
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October 1997. Cochrane reviews are regularly checked and updated if
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necessary.
Background: Amnioinfusion aims to prevent or relieve umbilical cord
compression during labour by infusing a solution into the uterine
cavity.
Objectives: The objective of this review was to assess the effects of
amnioinfusion on maternal and perinatal outcome for potential or
suspected umbilical cord compression or potential amnionitis.
Search strategy: The Cochrane Pregnancy and Childbirth Group trials
register and the Cochrane Controlled Trials Register were searched. Date
of last search: October 2001.
Selection criteria: Randomised trials of amnioinfusion compared with no
amnioinfusion in women with babies at risk of umbilical cord
compression; and women at risk of intrauterine infection.
Data collection and analysis: Eligibility and trial quality were
assessed by the reviewer.
Main results: Twelve studies were included. Transcervical amnioinfusion
for potential or suspected umbilical cord compression was associated
with the following reductions: fetal heart rate decelerations (relative
risk 0.54, 95% confidence interval 0.43 to 0.68); caesarean section for
suspected fetal distress (relative risk 0.35, 95% confidence interval
0.24 to 0.52); neonatal hospital stay greater than 3 days (relative risk
0.40, 95% confidence interval 0.26 to 0.62); maternal hospital stay
greater than 3 days (relative risk 0.46, 95% 0.29 to 0.74).
Transabdominal amnioinfusion showed similar results. Transcervical
amnioinfusion to prevent infection in women with membranes ruptured for
more than 6 hours was associated with a reduction in puerperal infection
(relative risk 0.50, 95% confidence interval 0.26 to 0.97).
Reviewers' conclusions: Amnioinfusion appears to reduce the occurrence
of variable heart rate decelerations and lower the use of caesarean
section. However the studies were done in settings where fetal distress
was not confirmed by fetal blood sampling. The results may therefore
only be relevant where caesarean sections are commonly done for abnormal
fetal heart rate alone. The trials reviewed are too small to address
the possibility of rare but serious maternal adverse effects of
amnioinfusion.
Citation: Hofmeyr GJ. Amnioinfusion for umbilical cord compression in
labour (Cochrane Review). In: The Cochrane Library, 1, 2002. Oxford:
Update Software.
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This is an abstract of a regularly updated, systematic review prepared
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and maintained by the Cochrane Collaboration. The full text of the
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review is available in The Cochrane Library (ISSN 1464-780X).
The Cochrane Library is prepared and published by Update Software Ltd.
All rights reserved.
See http://www.update-software.com or contact Update Software,
info@update.co.uk, for information on subscribing to The Cochrane
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File Reference: ab000013-20021
At Wed, 30 Jan 2002, RModugno@aol.com wrote:
>
>In a message dated 1/30/02 10:34:21 PM Eastern Standard Time,
>eryl@intekom.co.za writes:
>
>> I have certainly seen the dramatic
>> disappearance of late decelerations after amnioinfusion in some cases.
>
>Stray, I thought it only worked for variable decelerations?
>
>Robert Modugno MD MBA FACOG
>Marietta, GA
>http://www.novaobgyn.yourmd.com
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