Pumps and warmers during amnioinfusion: is either necessary?
OBJECTIVE
To determine if there is evidence from published reports that the use of infusion pumps or solution warmers during amnioinfusion is beneficial.


METHODS
We identified all English-language amnioinfusion reports published since 1983 through Medline and references.


METHODS
Fourteen prospective papers with at least 40 subjects were identified.


METHODS
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 (OR 0.56). There were no demonstrable benefits associated with the use of warmers or pumps. In multiple regression analysis, infusion pumps were associated with a significantly increased risk of fetal distress (P = .01).


CONCLUSIONS
The use of amnioinfusion is associated with a decreased risk of fetal distress, meconium below the cords, and cesarean delivery. To date, there is no demonstrable benefit using infusion pumps or solution warmers during amnioinfusion.
Department of Obstetrics and Gynecology, University of Rochester, School of Medicine and Dentistry, New York, USA.
J C
JC
Glantz
D L
DL
Letteney
D000650:Amnion; D005260:Female; D006358:Hot Temperature; D006801:Humans; D007260:Infusion Pumps; D007263:Infusions, Parenteral; D016017:Odds Ratio; D011247:Pregnancy; D011256:Pregnancy Outcome