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Re: Amnio infusionFrom: R. Daniel Braun (rBraun@IUNET.IUPUI.EDU)Wed Jul 3 15:22:49 1996
We utilize amnioinfusion routinely in the management of severe variable decelerations and in the management of meconium in the amniotic fluid. By replacing the fluid aropund the cord one protects it from compression. We feel that we significantly decrease the C/S rate for cord compression with the use of this technique. The literature backs this up in several articles. Its use in the presence of meconium is slightly more controversial. I think the generally accepted feeling is that it seems to prevent meconium aspiration by preventing cord compression which then prevents fetal gasping in-utero. It also certainly does dilute the meconium, but that may not be such a good thing because if it is thin the fetus might be more easily able to aspirate it. ??????? There are mutliple techniques described in the literature. Some involve measuring an AFI on a regular basis until there is enough fluid present (a most reasonable approach to my thinking) and others call for infusion of varying amounts per varying units of time. If one infuses too much or doesn't let enough run back out, there is a risk of overdistention of the uterus with subsequent hypertonus and fetal distress or perhaps even ??uterine rupture??? There have been some questions raised about infection, but I am not aware of any studies showing this to be a real problem. I am a real advocate and have been for about 6 years. I feel ti is a really great technique for preventing abdominal deliveries in patients with too little fluid.
-- @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@ R.Daniel Braun, MD FACOG "Money will buy you a fine dog, Clinical Professor but only love will make it wag Dept. OB/GYN it's tail." Indiana U. School of Medicine Richard "Kinky"Friedman Racetown @@@@@@@@@@@@@@@@@@@@@@@@@@@@@@@
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