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Amnioinfusion

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141. Intrapartum amnioinfusion for meconium-stained amniotic fluid: a systematic review of randomised controlled trials. (PubMed)

Intrapartum amnioinfusion for meconium-stained amniotic fluid: a systematic review of randomised controlled trials. Amnioinfusion (AI) is thought to dilute meconium when present in the amniotic fluid and so reduces the risk of meconium aspiration.To evaluate if AI reduces meconium aspiration syndrome (MAS) and other indicators of morbidity in babies born to women with meconium-stained amniotic fluid (MSAF).PubMed, Medline, EMBASE, and the Cochrane Controlled Trials Register from January 1980 (...) to May 30, 2005, using the keywords 'amnioinfusion' and 'meconium'.Randomised trials comparing AI with no AI for women in labour with MSAF. Trial quality was evaluated using pre-established criteria.The following morbidity indicators were assessed: MAS, 5-minute Apgar score < 7, arterial cord pH < 7.2, and caesarean section. Studies were stratified according to the level of peripartum surveillance (standard versus limited). Typical relative risks (RRs) with their 95% confidence intervals were

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2007 BJOG

142. Intrapartum amnioinfusion for meconium-stained amniotic fluid: a systematic review of randomised controlled trials. (PubMed)

Intrapartum amnioinfusion for meconium-stained amniotic fluid: a systematic review of randomised controlled trials. 17995503 2008 01 15 2007 11 12 1471-0528 114 12 2007 Dec BJOG : an international journal of obstetrics and gynaecology BJOG Intrapartum amnioinfusion for meconium-stained amniotic fluid: a systematic review of randomised controlled trials. 1582-3; author reply 1583-4 Jana N N Barik S S Arora N N eng Comment Letter England BJOG 100935741 1470-0328 AIM IM BJOG. 2007 Apr;114(4):383

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2007 BJOG

143. Small-volume amnioinfusion: a potential stimulus of intrapartum fetal heart rate accelerations. (PubMed)

Small-volume amnioinfusion: a potential stimulus of intrapartum fetal heart rate accelerations. We describe a recurrent nonreassuring fetal heart rate pattern in which small-volume amnioinfusions apparently evoked fetal heart rate accelerations suggested fetal well-being, allowing that progressive labor that culminated in the vaginal delivery of a healthy infant.

2004 American Journal of Obstetrics and Gynecology

144. Successful external cephalic version after amnioinfusion in a patient with preterm premature rupture of membranes. (PubMed)

Successful external cephalic version after amnioinfusion in a patient with preterm premature rupture of membranes. After hospitalization subsequent to preterm premature rupture of membranes at 29 weeks, our patient was scheduled for induction of labor at 34 weeks. When the fetus was found to be breech with oligohydramnios, amnioinfusion was performed to facilitate external cephalic version, and this successful procedure enabled the patient to deliver vaginally.

2005 American Journal of Obstetrics and Gynecology

145. Amnioinfusion to facilitate external cephalic version after initial failure. (PubMed)

Amnioinfusion to facilitate external cephalic version after initial failure. To evaluate the effectiveness of antepartum transabdominal amnioinfusion to facilitate external cephalic version after initial failure.Women with a structurally normal fetus in breech lie at term, with a failed external cephalic version and an amniotic fluid index (AFI) less than 15 cm, were asked to participate in our study. After tocolysis with indomethacin, a transabdominal amnioinfusion was performed with an 18G (...) spinal needle. Lactated Ringers solution was infused until the AFI reached 15 cm, with a maximum of 1 L. External cephalic version was performed directly afterward.Seven women participated in the study. The gestational age of the women was between 36(+4) and 38(+3) weeks, and three women were primiparous. The AFI ranged from 4 cm to 13 cm. A median amount of 1,000 mL Ringers solution (range 700-1,000 mL) was infused per procedure. The repeat external cephalic versions after amnioinfusion were

2006 Obstetrics and Gynecology

146. Prophylactic transcervical amnioinfusion in laboring women with oligohydramnios. (PubMed)

Prophylactic transcervical amnioinfusion in laboring women with oligohydramnios. Evaluation of prophylactic intrapartum amnioinfusion in women with oligohydramnios.Assiut University Hospital during the period from February 2000 to September 2001, 160 laboring women with oligohydramnios [amniotic fluid index (AFI) amnioinfusion and control groups. Inclusion criteria were: term singleton gestation, vertex presentation, cervical dilatation <4 cm, and assuring fetal (...) heart rate (FHR). Trans-cervical amnioinfusion was done with warmed normal saline.there was a significant increase in AFI after amnioinfusion (P<0.001). The amnioinfusion group showed lower cesarean section rate for fetal distress (P=0.003), lower incidence of abnormal FHR (P=0.006), fewer neonates with Apgar score <7 at 1 min (P<0.001), and 5 min (P=0.009), meconium below vocal cords (P<0.001), umbilical arterial pH<7.1 (P=0.003), and significantly shorter hospital stay (P=0.02).Prophylactic trans

2003 International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics Controlled trial quality: uncertain

147. Amnioinfusion in thick meconium. (PubMed)

Amnioinfusion in thick meconium. There are conflicting reports regarding the results of amnioinfusion in the management of meconium passage in utero. This study was done to evaluate transcervical amnioinfusion for meconium stained amniotic fluid during labour.196 women at term in early labour with meconium were randomized to receive either transcervical intrapartum amnioinfusion with saline (96) or routine obstetrical care (100). Transcervical amnioinfusion of one liter saline infused over 30 (...) was reduced from 48% to 17% (p< 0.004) using amnioinfusion with positive X-rays for meconium aspiration in only 12.5% versus 26% (p < 0.5).We concluded that transcervical intrapartum amnioinfusion is a safe, simple and inexpensive technique that reduces operative intervention and improves neonatal outcome, and is of tremendous relevance in developing countries.

2004 Indian journal of pediatrics Controlled trial quality: uncertain

148. Transcervical intrapartum amnioinfusion for preterm premature rupture of the membranes. (PubMed)

Transcervical intrapartum amnioinfusion for preterm premature rupture of the membranes. To investigate the effect of transcervical amnioinfusion on the management of labour and neonatal outcomes in preterm premature rupture of the membranes.This clinical trial included 86 patients with premature rupture of the membranes between weeks 27 and 35 of gestation. Patients were randomly assigned to receive amnioinfusion via a two-way catheter or to the control group. Clinical management was otherwise (...) the same in both groups.Amnioinfusion decreased the frequency of variable decelerations in fetal heart rate (27.9% versus 53.5%, p<0.05) and the rate of obstetric interventions motivated by nonreassuring fetal status (13.6% versus 52.4%, p<0.05). At delivery, pH values were significantly higher in the treatment group than in the conventionally managed control group (median 7.29 versus 7.27).Intrapartum transcervical amnioinfusion for preterm premature rupture of the membranes reduced the number

2007 European journal of obstetrics, gynecology, and reproductive biology Controlled trial quality: uncertain

149. Therapeutic amnioinfusion for intrapartum fetal distress using a pediatric feeding tube. (PubMed)

Therapeutic amnioinfusion for intrapartum fetal distress using a pediatric feeding tube. To evaluate the role of therapeutic amnioinfusion using a pediatric feeding tube in cases of intrapartum fetal distress.A randomized clinical trial including 438 women admitted in labor at Assiut University Hospital with nonreassuring fetal heart rate tracing. Using sealed opaque envelopes, the women were randomized to 2 groups. In the amnioinfusion group they underwent transcervical amnioinfusion (1000 mL (...) of warmed sterile saline solution) in addition to conventional treatment. In the control group they received conventional treatment only. The primary outcome was cesarean section rate for fetal distress. The secondary outcomes were neonatal and maternal complications.The amnioinfusion group showed a significant reduction in the rate of cesarean section for fetal distress (relative risk [RR], 0.7; 95% confidence interval [CI], 0.6-0.83), and a 30% reduction in abnormal fetal heart rate patterns (RR, 0.7

2005 International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics Controlled trial quality: predicted high

150. Transabdominal amnioinfusion in preterm premature rupture of membranes: a randomised controlled trial. (PubMed)

Transabdominal amnioinfusion in preterm premature rupture of membranes: a randomised controlled trial. To evaluate the role of transabdominal amnioinfusion in improving the perinatal outcomes of pregnancies complicated by preterm premature rupture of membranes (pPROM).A randomised controlled trial.A teaching hospital in Italy, obstetric unit. Population Women with singleton pregnancies complicated by pPROM, between 24 + 0 and 32 + 6 weeks of gestation.Patients were randomised 24 hours after (...) admission to our referral hospital, to expectant management with transabdominal amnioinfusion or expectant management only.The effects of transabdominal amnioinfusion on pPROM-delivery interval and on perinatal outcomes.Of the 65 women with pPROM 34 met the inclusion criteria. Seventeen women were assigned to amnioinfusion (the amnioinfusion group) and the other 17 to expectant management. Compared with the control group (median: 8 days; range: 3-14), the pPROM-delivery period was significantly longer

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2005 BJOG Controlled trial quality: predicted high

151. A controlled trial of amnioinfusion: the prevention of meconium aspiration in labour. (PubMed)

A controlled trial of amnioinfusion: the prevention of meconium aspiration in labour. The purpose of this study was to examine the effect of amnioinfusion on the incidence of meconium aspiration syndrome, perinatal asphyxia and obstetrical intervention rate amongst patients with moderate and thick meconium-stained liquor. A total of 112 patients were studied in a prospective fashion; 60 received amnioinfusion and 52 served as controls. We have shown that amnioinfusion is a simple, relatively

1993 The Australian & New Zealand journal of obstetrics & gynaecology

152. [Multicenter randomized trial of amnioinfusion]. (PubMed)

[Multicenter randomized trial of amnioinfusion]. Meconium staining of the amniotic fluid in labor is a frequent problem that is associated with an increase in the risk of neonatal and maternal morbidity. Amnioinfusion is a simple technique that is designed to prevent neonatal and maternal morbidity associated with meconium. Preliminary studies indicate that amnioinfusion is a promising approach to the prevention of such complications of labor. However, further research is required. The primary (...) objective of this multi-centre randomized controlled study is to determine if amnioinfusion for thick meconium stained amniotic fluid results in a reduction in perinatal death or moderate to severe meconium aspiration syndrome. We will also assess the effects of amnioinfusion on other indicators of neonatal morbidity and on cesarean section. The study includes an evaluation of womens views on their childbirth experience and an economic evaluation of a policy of amnioinfusion The study will be achieved

2000 Journal de gynécologie, obstétrique et biologie de la reproduction

153. Prophylactic amnioinfusion for intrapartum oligohydramnios: a meta-analysis of randomized controlled trials. (PubMed)

Prophylactic amnioinfusion for intrapartum oligohydramnios: a meta-analysis of randomized controlled trials. To evaluate the effectiveness of intrapartum prophylactic amnioinfusion in pregnancies complicated by oligohydramnios.Randomized controlled trials of prophylactic amnioinfusion in women with oligohydramnios were identified using computerized databases, index reviews, and references cited in original studies and review articles.We evaluated, abstracted data from, and analyzed randomized (...) studies of prophylactic intrapartum amnioinfusion in women with oligohydramnios. In every study the group allocation was based exclusively on presence of oligohydramnios. Only published studies with clearly documented outcome data were included. The quality of each trial was evaluated for methodology, inclusion and exclusion criteria, adequacy of randomization, amnioinfusion protocols, definition of outcomes, and statistical analyses. The trials were evaluated concerning cesarean deliveries for fetal

2000 Obstetrics and Gynecology

154. Intrapartum amnioinfusion for meconium-stained fluid: meta-analysis of prospective clinical trials. (PubMed)

Intrapartum amnioinfusion for meconium-stained fluid: meta-analysis of prospective clinical trials. To evaluate the effectiveness of intrapartum prophylactic amnioinfusion in pregnancies complicated by meconium-stained amniotic fluid.We identified prospective clinical trials of amnioinfusion in pregnancies complicated by meconium-stained amniotic fluid (AF) published in English by using computerized databases, references in published studies, and index reviews.We analyzed prospective studies (...) of intrapartum amnioinfusion for meconium-stained AF. In every case, group allocation was based exclusively on meconium in AF. Only published studies with clearly documented outcome data were included. The trials were evaluated for meconium below the vocal cords, meconium aspiration syndrome, fetal acidemia, cesarean delivery, and postpartum endometritis. Each trial was evaluated for the quality of its methodology, inclusion and exclusion criteria, adequacy of randomization, amnioinfusion protocols

2000 Obstetrics and Gynecology

155. The effect of amnioinfusion on the duration of labor. (PubMed)

The effect of amnioinfusion on the duration of labor. To test the hypothesis that women receiving intrapartum amnioinfusion have more rapid labors than do controls.Prospective clinical trials of amnioinfusion published in major American obstetric and gynecologic journals between 1985 and 1995, identified through a literature search using MEDLINE and manual index review, were examined.Eleven studies that presented data regarding the length of labor were identified. Each study was reviewed (...) for the design, number of subjects enrolled, volume of amnioinfusate, birth weight, maternal parity, interval from amniorrhexis to delivery, and total length of labor.Meta-analysis revealed no differences between amnioinfusion groups and controls with regard to length of labor or the interval between membrane rupture and delivery.Amnioinfusion has no effect on the duration of labor.

1997 Obstetrics and Gynecology

156. Pumps and warmers during amnioinfusion: is either necessary? (PubMed)

Pumps and warmers during amnioinfusion: is either necessary? To determine if there is evidence from published reports that the use of infusion pumps or solution warmers during amnioinfusion is beneficial.We identified all English-language amnioinfusion reports published since 1983 through Medline and references.Fourteen prospective papers with at least 40 subjects were identified.For the amnioinfusion and control groups in each study, odds ratios (OR) were calculated for cesarean delivery (...) , fetal distress, meconium below the cords, low 5-minute Apgar score, and endometritis. Cumulative ORs were calculated using the Mantel-Haenszel inverse variance method. This process was repeated after separation into pump-gravity and warmed-unwarmed groups. Multiple regression analyses were performed. Amnioinfusion improved the ability of the fetus to tolerate labor (fetal distress OR 0.40), decreased the incidence of meconium below the cords (OR 0.16), and decreased the rate of cesarean delivery

1996 Obstetrics and Gynecology

157. Amnioinfusion and the intrauterine prevention of meconium aspiration. (PubMed)

Amnioinfusion and the intrauterine prevention of meconium aspiration. We evaluated the published literature on the effectiveness of amnioinfusion in reducing meconium below the vocal cords and meconium aspiration syndrome among infants born to women presenting with more than trace meconium-stained fluid.A literature search was conducted to evaluate clinical trials of amnioinfusion and meconium aspiration. Trials meeting certain basic design criteria (n = 5), which included a prospective study (...) design and blinded assessment of newborn outcome, were selected for statistical analyses estimating the average effect's size and direction. In total, 247 women with meconium-stained fluid receiving amnioinfusion and 260 women with meconium-stained fluid not receiving amnioinfusion were represented by these trials.Infants born to women with meconium-stained fluid receiving amnioinfusion were less likely to have meconium below the vocal cords (odds ratio 0.13, 95% confidence interval 0.08 to 0.20

1995 American journal of obstetrics and gynecology

158. Prophylactic intrapartum amnioinfusion in patients with preterm premature rupture of membranes. (PubMed)

Prophylactic intrapartum amnioinfusion in patients with preterm premature rupture of membranes. Patients with preterm premature rupture of the membranes are at increased risk to develop intrapartum variable decelerations and fetal distress. Short-term saline solution amnioinfusion may be of benefit in the treatment of variable or prolonged decelerations once they appear. In an effort to assess the benefit of prophylactic amnioinfusion, patients with preterm premature rupture of the membranes (...) were studied during a 1-year period in a prospective randomized manner. Patients receiving prophylactic amnioinfusion had significantly decreased incidence and severity of variable decelerations in the first stage of labor (p less than 0.005). In the second stage of labor, the incidence of severe (p less than 0.005) and total (p less than 0.001) decelerations was also decreased in the treatment group. The umbilical arterial pH at delivery was significantly lower (p less than 0.001

1985 American journal of obstetrics and gynecology Controlled trial quality: uncertain

159. Saline amnioinfusion for relief of repetitive variable decelerations: a prospective randomized study. (PubMed)

Saline amnioinfusion for relief of repetitive variable decelerations: a prospective randomized study. A prospective randomized study was undertaken in order to further investigate the effect of intrauterine saline amnioinfusion for the relief of repetitive variable decelerations in the first stage of labor. Intrauterine saline amnioinfusion corrects the oligohydramnios that makes the cord more vulnerable to compression during uterine contractions. Included in this study were 96 patients who had (...) of cesarean sections for fetal distress, being 14.8% in the infusion group as compared to 47.6% in the noninfusion group. This study clearly showed that saline amnioinfusion is a logical, simple, safe, and effective therapy for the relief of repetitive variable decelerations in the first stage of labor and can lower the incidence of cesarean sections for fetal distress in nulliparous patients. Furthermore, amnioinfusion was much superior to changes in position in treating repetitive variable decelerations.

1985 American journal of obstetrics and gynecology Controlled trial quality: uncertain

160. The prevention of meconium aspiration in labor using amnioinfusion. (PubMed)

The prevention of meconium aspiration in labor using amnioinfusion. In an effort to improve maternal and fetal outcome in patients laboring with thick meconium, 85 patients presenting with thick meconium were randomized to receive either amnioinfusion with 1000 mL normal saline initially and every 6 hours until delivery, or routine care. Meconium was discovered on initial examination during labor, after artificial rupture of membranes, through the use of an intrauterine pressure catheter (...) , or on amniocentesis. Labor management was otherwise routine. Forceps operations and cesarean sections were for distress or failure to progress, as indicated. Patients receiving amnioinfusion had significantly fewer low 1-minute Apgar scores, less meconium below the cords, and a significantly lower incidence of operative delivery. The only three cases of meconium aspiration syndrome occurred in infants delivered of patients receiving routine management. No adverse side effects of amnioinfusion were detected

1989 Obstetrics and Gynecology Controlled trial quality: uncertain

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