The effect of amnioinfusion on uterine pressure and activity: a preliminary report.
Transcervical intrapartum amnioinfusion of normal saline solution is being used in a number of centers. Over the past few years indications for the procedure have included prophylaxis and treatment of intrapartum decelerations in both term and preterm gestations, dilution and lavage of meconium-stained amniotic fluid, and for direct administration of antibiotics within the amniotic cavity in cases of chorioamnionitis. Little is reported about the real or potential risks of this procedure to both the mother and fetus. Over the past 2 years we observed several isolated cases of increased uterine activity by palpation coupled with fetal distress during amnioinfusion. These instances prompted us to study in a systematic fashion the relationships between uterine tone and activity during intrapartum amnioinfusion. We measured uterine tone and quantitated uterine activity in 10 patients undergoing intrapartum amnioinfusion and compared values 20 minutes before, during, and 20 minutes after amnioinfusion. A significant increase in uterine tone (p less than 0.05) was noted during and after the infusion. No difference in uterine activity was observed in any of the study periods. A case of uterine hypertonus and fetal bradycardia and a suggested procedure scheme for intrapartum amnioinfusion are presented.
Posner
M D
MD
Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles County-University of Southern California Medical Center.
Ballagh
S A
SA
Paul
R H
RH
D000653:Amniotic Fluid / Q000502:physiology*; D000704:Analysis of Variance; D005260:Female; D006340:Heart Rate, Fetal; D006801:Humans; D011247:Pregnancy; D011312:Pressure; D014590:Uterine Contraction / Q000502:physiology; D014599:Uterus / Q000502:physiology*