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Amnioinfusion

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161. Amnioinfusion during labor complicated by particulate meconium-stained amniotic fluid decreases neonatal morbidity. (Abstract)

Amnioinfusion during labor complicated by particulate meconium-stained amniotic fluid decreases neonatal morbidity. Our purpose was to evaluate the efficacy of prophylactic amnioinfusion in decreasing neonatal morbidity associated with labor complicated by particulate meconium-stained amniotic fluid and to assess potential complications of this procedure.One hundred five laboring pregnant women with particulate (moderate or thick) meconium by subjective clinical analysis were randomly assigned (...) to receive amnioinfusion or to receive standard obstetric care without amnioinfusion. Patients with any antepartum complications, other than the presence of meconium, were excluded from the study. Statistical analyses consisted of the two-tailed and paired Student t tests, Pearson chi 2 test, and Wilcoxon nonparametric test. Significance was set at p < 0.05.The study included 47 patients in the study group and 58 patients in the control group. A significantly greater proportion of study patients

1994 American journal of obstetrics and gynecology Controlled trial quality: uncertain

162. Transabdominal amnioinfusion in oligohydramnios at term before induction of labor with intact membranes: a randomized clinical trial. (Abstract)

Transabdominal amnioinfusion in oligohydramnios at term before induction of labor with intact membranes: a randomized clinical trial. Our purpose was to determine the effectiveness of transabdominal amnioinfusion before induction of labor in reducing the incidence of fetal distress in pregnancies with oligohydramnios at term.Between June 1991 and September 1994 primiparous women with ultrasonographic evidence of oligohydramnios at term, intact membranes, and unripe cervix (Bishop score < or = 6 (...) ), candidates for induction of labor with cervical or vaginal prostaglandin E2 gel, were randomly selected to receive transabdominal amnioinfusion (amnioinfused group, n = 39) or to proceed with direct labor induction (control group, n = 40). Inclusion criteria were (1) singleton gestation, (2) vertex presentation, (3) ultrasonographic estimation of fetal weight > or = 2500 gm, and (4) reactive nonstress test. Fetoneonatal outcome variables were compared between the two groups. Statistical analysis used

1996 American journal of obstetrics and gynecology Controlled trial quality: uncertain

163. A prospective randomized trial of two solutions for intrapartum amnioinfusion: effects on fetal electrolytes, osmolality, and acid-base status. (Abstract)

A prospective randomized trial of two solutions for intrapartum amnioinfusion: effects on fetal electrolytes, osmolality, and acid-base status. Our purpose was to compare the effects of intrapartum amnioinfusion with normal saline solution versus lactated Ringer's solution plus physiologic glucose on neonatal electrolytes and acid-base balance.Patients undergoing amnioinfusion for obstetric indications were randomized to receive normal saline solution or lactated Ringer's solution plus (...) physiologic glucose at standardized amnioinfusion rates. Data were collected prospectively on maternal demographics, course of labor, and maternal and neonatal outcome. Arterial cord blood was obtained for analysis of electrolytes, glucose, osmolality, lactic acid, and blood gases. Control subjects with normal fetal heart rate patterns, and clear amniotic fluid not receiving amnioinfusion were studied concurrently.Data were collected on 59 patients (21 normal saline solution, 18 lactated Ringer's solution

1996 American journal of obstetrics and gynecology Controlled trial quality: uncertain

164. Neonatal electrolyte response to amnioinfusion with lactated Ringer's solution vs. normal saline. A prospective study. (Abstract)

Neonatal electrolyte response to amnioinfusion with lactated Ringer's solution vs. normal saline. A prospective study. To determine if amnioinfusion with normal saline vs. lactated Ringer's solution crystalloids causes electrolyte imbalance in the human neonate.Over two months, all parturients undergoing amnioinfusion in the active phase of labor were prospectively randomized to receive either normal saline (n = 37) or lactated Ringer's solution (n = 30). Maternal electrolytes were obtained (...) prior to amnioinfusion, and neonatal electrolytes were obtained from cord blood samples at the time of delivery.Our results showed the two groups were similar in maternal age, ethnicity, gravidity, parity, gestational age, maternal electrolyte levels prior to amnioinfusion, amount of solution amnioinfused, duration of labor after amnioinfusion, mode of delivery and mean birth weight. The chloride concentrations were nearly identical among neonates who had received normal saline and those who had

1996 Journal of Reproductive Medicine Controlled trial quality: uncertain

165. Intrapartum amnioinfusion for meconium-stained liquor in developing countries. (Abstract)

Intrapartum amnioinfusion for meconium-stained liquor in developing countries. Intrapartum amnioinfusion (AI) has been reported to decrease perinatal mortality and morbidity in women with meconium-stained liquor. Such work has not previously been performed at King Edward VIII Hospital (KEH), in a developing country, where the incidence of meconium-stained liquor is said to be extremely high.To establish whether AI during the intrapartum period for meconium-stained liquor decreases Caesarean (...) section rates for fetal distress and decreases perinatal morbidity.Informed consent was obtained from patients in labour who were 3-8 cm dilated, with meconium-staining of the liquor, grades I to III inclusive, and who had a normal cardiotocograph on presentation at term. Sixty patients were included in the trial; 30 had AI. The control group was managed by standard methods. The study group had an amnioinfusion of 0.9% normal saline at 15 ml/min under continuous cardiotocographic monitoring, until

1998 Tropical Doctor Controlled trial quality: uncertain

166. Lipid peroxidation in cord blood: a randomised sequential pairs study of prophylactic saline amnioinfusion for intrapartum oligohydramnios. (Abstract)

Lipid peroxidation in cord blood: a randomised sequential pairs study of prophylactic saline amnioinfusion for intrapartum oligohydramnios. To determine the efficacy of prophylactic intrapartum amnioinfusion in reducing cord arterial lipid peroxide levels in cases of intrapartum oligohydramnios.Sequential randomised pairs trial.Delivery suite of a teaching hospital, the Chinese University of Hong Kong.Women with singleton, term pregnancy, cephalic presentation, clear amniotic fluid (...) and an amniotic fluid index < or = 5 cm, with a normal intrapartum fetal heart rate tracing within 30 minutes of amniotomy.Selected patients were randomised either for prophylactic saline amnioinfusion or as control cases. Cord arterial lipid peroxide concentrations and acid base balance were determined at delivery.Operative intervention for fetal distress, cord arterial malondialdehyde and organic hydroperoxide levels, pH and base excess.Amnioinfusion was associated with significant reductions

1997 British journal of obstetrics and gynaecology Controlled trial quality: uncertain

167. The Collaborative Randomised Amnioinfusion for Meconium Project (CRAMP): 1. South Africa. (Abstract)

The Collaborative Randomised Amnioinfusion for Meconium Project (CRAMP): 1. South Africa. To evaluate transcervical amnioinfusion for meconium stained amniotic fluid during labout.Multicentre randomised controlled trial.Four urban academic hospitals in South Africa. Obstetric surveillance included the use of electronic fetal heart rate monitoring in most cases.Women in labour at term with moderate or thick meconium staining of the amniotic fluid.Transcervical amnioinfusion of 800 mL saline (...) at 15 mL per minute, followed by a maintenance infusion at 3 mL per minute. The control group received routine care. Blinding of the intervention was not possible.Caesarean section, meconium aspiration syndrome and perinatal mortality.Caesarean section rates were similar (amnioinfusion group 70/167 vs control group 68/159; RR 0.98, 95% CI 0.76-1.26). The incidence of meconium aspiration syndrome was lower than expected on the basis of previous studies (4/162 vs 6/163; RR 0.67, 95% CI 0.19-2.33

1998 British journal of obstetrics and gynaecology Controlled trial quality: predicted high

168. The Collaborative Randomised Amnioinfusion for Meconium Project (CRAMP): 2. Zimbabwe. (Abstract)

The Collaborative Randomised Amnioinfusion for Meconium Project (CRAMP): 2. Zimbabwe. To evaluate transcervical amnioinfusion for meconium stained amniotic fluid during labour.Multicentre randomised controlled trial.A large urban academic hospital. Electronic fetal heart rate monitoring was not used.Women in labour at term with moderate or thick meconium staining of the amniotic fluid.Transcervical amnioinfusion of 500 mL saline over 30 minutes, then 500 mL at 30 drops per minute. The control (...) group received routine care. Blinding of the intervention was not possible.Caesarean section, meconium aspiration syndrome and perinatal mortality.There was no difference in risk for caesarean section in the two groups (amnioinfusion 9.5% vs control 12.3%; RR 0.84, 95% CI 0.53-1.32). Meconium aspiration syndrome was significantly less frequent in the amnioinfusion group (3.1% vs 12.8%; RR 0.24, 95% CI 0.12-0.48), and there was a trend towards fewer perinatal deaths (1.2% vs 3.6%; RR 0.34, 95% CI

1998 British journal of obstetrics and gynaecology Controlled trial quality: uncertain

169. Amnioinfusion in labor induction of term pregnancies with premature rupture of the membranes and low amniotic fluid. (Abstract)

Amnioinfusion in labor induction of term pregnancies with premature rupture of the membranes and low amniotic fluid. To analyze the utility of prophylactic amnioinfusion in term pregnancies with PROM and a low amniotic fluid index during labor induction.Forty-two women with amnioinfusion and 42 in a control group with amniotic fluid index (AFI) below 10 cm when admitted to labor induction were studied. All patients had electronic fetal heart rate and intrauterine pressure continuous monitoring (...) . Amnioinfusion of normal saline (37 degrees C) was realized in the study group, using a continuous perfusion pump at 600 ml/h for 1 h, after which the AFI was again recorded; if this was < 15, the perfusion was continued at 180 ml/h until full cervical dilatation was achieved or until uterine baseline activity reached 20 mm Hg. The control group received identical obstetric care except in respect of amnioinfusion.Both groups were similar in age, primiparity, gestational age, initial AFI, interval from

1998 International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics Controlled trial quality: uncertain

170. Amnioinfusion does not affect the length of labor. (Abstract)

Amnioinfusion does not affect the length of labor. Our objective was to determine whether amnioinfusion prolongs or shortens the length of labor in patients who have an accepted indication for amnioinfusion.We performed a retrospective post hoc analysis of the length of labor of 437 patients who were enrolled in three prospective, randomized, controlled studies of amnioinfusion.The length of labor was not significantly different for patients who received amnioinfusion compared with those who (...) did not receive amnioinfusion (control group). Among the subgroup with vaginal delivery, the duration of labor after amnioinfusion did not differ from the duration of labor among the controls. The length of labor (mean +/- SD, in hours) for the amnioinfusion group was 9.3 +/- 6.3 versus 10.6 +/- 6.9 for the control groups (p not significant). Among the subgroup that required cesarean delivery, the duration of labor after amnioinfusion did not differ from the duration of labor among the controls

1992 American journal of obstetrics and gynecology Controlled trial quality: uncertain

171. Prophylactic amnioinfusion improves outcome of pregnancy complicated by thick meconium and oligohydramnios. (Abstract)

Prophylactic amnioinfusion improves outcome of pregnancy complicated by thick meconium and oligohydramnios. The null hypothesis is that the use of intrapartum amnioinfusion in labors complicated by the presence of thick meconium and oligohydramnios will not decrease the incidence of fetal distress, cesarean delivery, meconium aspiration, or meconium aspiration syndrome.One hundred seventy term and postterm patients with thick meconium and oligohydramnios were randomly chosen to receive (...) amnioinfusion or standard obstetric care without amnioinfusion. The frequency of fetal distress, cesarean section, meconium aspiration, and meconium aspiration syndrome were subject to chi 2 analysis, Student's t test, or Fisher's exact test.The rate of fetal distress was significantly reduced in the amnioinfusion group compared with controls (three of 85 vs 19 of 85, relative risk 0.15, 95% confidence interval 0.06 to 0.42). The rate of cesarean section for fetal distress was significantly reduced

1992 American journal of obstetrics and gynecology Controlled trial quality: uncertain

172. A controlled trial of amnioinfusion: the prevention of meconium aspiration in labour. (Abstract)

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

173. Prophylactic intrapartum amnioinfusion for patients with oligohydramnios. A prospective randomized study. (Abstract)

Prophylactic intrapartum amnioinfusion for patients with oligohydramnios. A prospective randomized study. This prospective study evaluated whether prophylactic saline amnioinfusion among patients with amniotic fluid index (AFI) < or = 5.0 cm decreases the incidence of adverse fetal outcomes. Randomization of 53 patients with decreased AFI at term, resulted in 21 patients' receiving prophylactic saline amnioinfusion early in labor, prior to development of an abnormal fetal heart rate tracing (...) . For the treatment group the mean AFI on admission was 3.0 cm, and the postamnioinfusion AFI was 8.9 cm. For 32 comparison (noninfusion) patients, the mean AFI was 2.9 cm; the group consisted of 17 patients randomized to receive no amnioinfusion (control group) and 15 patients who refused to participate in the study. There was no statistically significant difference between the amnioinfused and nonamnioinfused patients with regard to age, parity, gestational age, AFI at admission or duration of first or second

1992 Journal of Reproductive Medicine Controlled trial quality: uncertain

174. Prophylactic cefazolin in amnioinfusions administered for meconium-stained amniotic fluid. (Full text)

Prophylactic cefazolin in amnioinfusions administered for meconium-stained amniotic fluid. To determine if amnioinfusion with an antibiotic solution decreased the rate of clinical chorioamnionitis and puerperal endometritis in patients with meconium-stained amniotic fluid.Patients in labor at 36 weeks of gestation or greater with singleton pregnancies and meconium-stained amniotic fluid were randomized to receive either cefazolin, 1 g/1,000 mL, of normal saline (n = 90) or normal saline (n = 93 (...) ) amnioinfusion. Rates of clinically diagnosed chorioamnionitis and endometritis and of suspected and culture-proven neonatal infection were determined.Between the study and control groups, the incidences of clinical chorioamnionitis (7.8% vs. 8.6%), endometritis (2.4% vs. 3.5%), aggregate intrauterine infection (10.0% vs. 11.8%), suspected neonatal infection (17.8% vs. 21.5%), and proven neonatal infection (0.0% vs. 2.2%) were not significantly different.Prophylactic use of cefazolin in amnioinfusions did

1999 Infectious diseases in obstetrics and gynecology Controlled trial quality: uncertain PubMed abstract

175. Amnioinfusion in term labor with low amniotic fluid due to rupture of membranes: a new indication. (Abstract)

Amnioinfusion in term labor with low amniotic fluid due to rupture of membranes: a new indication. The null hypothesis was that the use of intrapartum amnioinfusion to induce term labor because of premature rupture of membranes when labor was complicated by low amniotic fluid volume due to vaginal loss would not improve fetal heart rate patterns, decrease the incidence of operative delivery, or improve neonatal acid-base status.200 term pregnancies with low amniotic fluid due to vaginal loss (...) were randomly chosen to receive intrapartum amnioinfusion or standard obstetric care without amnioinfusion. Fetal heart rate pattern, method of delivery and neonatal acid-base status were compared with Student's t test, chi-squared analysis, Mann-Whitney U- or Fisher's exact test.When amnioinfusion was used, the fetuses had lower rates of variable (74 vs. 91%, P<0.01) or late (26 vs. 58%, P<0.001) decelerations. Spontaneous deliveries were more frequent (77 vs. 59%, P<0.01) and cesarean sections

1999 European journal of obstetrics, gynecology, and reproductive biology Controlled trial quality: uncertain

176. Intrapartum amnioinfusion in women with oligohydramniosis. A prospective randomized trial. (Abstract)

Intrapartum amnioinfusion in women with oligohydramniosis. A prospective randomized trial. To evaluate the effects of amnioinfusion in oligohydramniosis.During a 20-month period, patients at term with oligohydramniosis (amniotic fluid index less than 5 cm) at Huddinge University and Norrköping Hospitals were recruited for a prospective randomized study to evaluate amnioinfusion. Informed consent was obtained from 112 patients who met the entry criteria. Sixty subjects were randomized (...) to amnioinfusion and 52 to the control group. Outcome parameters included fetal heart rate abnormalities, mode of delivery, Apgar score, pH in umbilical artery blood and need for neonatal intensive care.The cesarean section rate was significantly reduced in the amnio-infusion group (29% versus 13%, p=0.043). No difference in time from randomization to delivery was detected between the two groups. The frequency of ominous fetal heart rate tracings with a cervical dilatation of 0-3 cm was the same in the two

1999 Acta Obstetricia et Gynecologica Scandinavica Controlled trial quality: uncertain

177. Prophylactic transcervical amnioinfusion in laboring women with oligohydramnios. (Abstract)

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

178. [Multicenter randomized trial of amnioinfusion]. (Abstract)

[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

179. Randomized trial of intermittent or continuous amnioinfusion for variable decelerations. (Abstract)

Randomized trial of intermittent or continuous amnioinfusion for variable decelerations. To determine whether continuous or intermittent bolus amnioinfusion is more effective in relieving variable decelerations.Patients with repetitive variable decelerations were randomized to an intermittent bolus or continuous amnioinfusion. The intermittent bolus infusion group received boluses of 500 mL of normal saline, each over 30 minutes, with boluses repeated if variable decelerations recurred (...) . The continuous infusion group received a bolus infusion of 500 mL of normal saline over 30 minutes and then 3 mL per minute until delivery occurred. The ability of the amnioinfusion to abolish variable decelerations was analyzed, as were maternal demographic and pregnancy outcome variables. Power analysis indicated that 64 patients would be required.Thirty-five patients were randomized to intermittent infusion and 30 to continuous infusion. There were no differences between groups in terms of maternal

2000 Obstetrics and Gynecology Controlled trial quality: uncertain

180. Meconium concentration and amniotic fluid index influence the outcome of amnioinfusion. (Abstract)

Meconium concentration and amniotic fluid index influence the outcome of amnioinfusion. To determine the usefulness of amnioinfusion as a function of meconium concentration and amniotic fluid index.This was a prospective study of 206 pregnant women in whom amniotic fluid was moderately or heavily stained with meconium, according to subjective evaluation. The women were assigned randomly to receive amnioinfusion (n=103) or no amnioinfusion (control group, n=103). The results were compared (...) in women with =/<15 % or >15 % meconium in the amniotic fluid (measured by centrifugation), and in women in whom the amniotic fluid index calculated 60 min after insertion of the amnioinfusion catheter was <10 or =/>10.In women with >15% meconium, amnioinfusion decreased the rate of cesarian sections motivated by fetal distress (2.5% vs 22.2%), and in women with =/<15% meconium, amnioinfusion decreased the presence of meconium below the vocal cords (6.4% vs 25.9%). Greater benefits after amnioinfusion

2001 Minerva ginecologica Controlled trial quality: uncertain

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