Amnioinfusion in term labor with low amniotic fluid due to rupture of membranes: a new indication.
OBJECTIVE
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.


METHODS
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.


RESULTS
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 less frequent (3 vs. 10%, P<0.05). Mean umbilical arterial (7.24+/-0.07 vs. 7.21+/-0.08, P<0.01) and venous (7.31+/-0.06 vs. 7.28+/-0.08, P<0.01) pH were significantly higher in newborns with amnioinfusion, and babies in this group had lower rates of neonatal acidemia of arterial (22 vs. 36%, P<0.005) or venous (13 vs. 26%, P<0.005) origin.


CONCLUSIONS
Amnioinfusion improved fetal heart rate pattern, lowered the incidence of operative delivery, and improved neonatal acid-base status in term labor complicated by low amniotic fluid due to vaginal loss.
Miño
M
M
Department of Obstetrics and Gynecology, Virgen de las Nieves University Hospital, Granada, Spain.
Puertas
A
A
Miranda
J A
JA
Herruzo
A J
AJ
D000328:Adult; D000653:Amniotic Fluid / Q000502:physiology*; D001034:Apgar Score; D001724:Birth Weight; D002585:Cesarean Section; D005260:Female; D005312:Fetal Blood; D005322:Premature Rupture of Fetal Membranes / Q000628:therapy*; D005440:Fluid Therapy; D005865:Gestational Age; D006340:Heart Rate, Fetal; D006801:Humans; D007231:Infant, Newborn; D007751:Labor, Induced; D010121:Oxytocin / Q000627:therapeutic use; D011247:Pregnancy; D011446:Prospective Studies; D014882:Water-Electrolyte Balance
D010121:Oxytocin