Amnioinfusion in women with previous cesarean births: a preliminary report.
OBJECTIVE
Our purpose was to evaluate the use of intrapartum amnioinfusion in women undergoing a trial of labor after a previous cesarean delivery.


METHODS
Labor and delivery records of women undergoing intrapartum amnioinfusion over a 1-year period were reviewed retrospectively. Neonatal data were obtained by chart review.


RESULTS
During the study period 936 women underwent intrapartum amnioinfusion for the following indications: oligohydramnios (76.6%), meconium-stained amniotic fluid (12.8%),and variable decelerations (7.5%). Among these, 122 (13%) had previous cesarean births. Seventy-one (58.2%) women were delivered vaginally; the remaining 51 (41.8%) were delivered by repeat cesarean. Among women undergoing intrapartum amnioinfusion there were no statistically significant differences (p<0.05) between those with previous cesarean births and those with unscarred uteri with respect to the following: cesarean section for fetal distress (1.6% vs 1.4%), meconium aspiration (0% vs 0.9%), or low 5-minute Apgar scores (2.5% vs 0.9%). There were no perinatal or maternal deaths in either group. One uterine rupture occurred in a woman with one previous cesarean birth.


CONCLUSIONS
Amnioinfusion appears to be an acceptable procedure in women with previous cesarean births. The incidence of uterine rupture (0.8%) noted was similar to the 10-year institutional rate at Los Angeles County-University of Southern California Women's Hospital (0.7%).
Ouzounian
J G
JG
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Los Angeles County-University of Southern California Medical Center, Los Angeles 90033, USA.
Miller
D A
DA
Paul
R H
RH
D000328:Adult; D000650:Amnion; D002585:Cesarean Section; D017604:Cesarean Section, Repeat; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007263:Infusions, Parenteral / Q000009:adverse effects; D008471:Meconium Aspiration Syndrome / Q000517:prevention & control; D016104:Oligohydramnios / Q000628:therapy; D011247:Pregnancy; D012189:Retrospective Studies; D012965:Sodium Chloride / Q000008:administration & dosage; D014219:Trial of Labor; D014597:Uterine Rupture
D012965:Sodium Chloride