Amnioinfusion in the evaluation of fetal obstructive uropathy: the effect of antibiotic prophylaxis on complication rates.
OBJECTIVE
Amnioinfusion plays an important role in the intrauterine evaluation and treatment of fetal obstructive uropathy. However, it may significantly increase the risk for chorioamnionitis, premature rupture of membranes and premature labor. We evaluated the impact of prophylactic antibiotics on postamnioinfusion complications.


METHODS
Thirty pregnancies complicated by fetal obstructive uropathy, treated by amnioinfusion and with documentation of pregnancy outcome were identified from our database. Pregnancy outcomes were compared between patients who were treated with prophylactic antibiotics and those with no prophylaxis.


RESULTS
Chorioamnionitis was diagnosed in 3 out of 15 (20%) patients who did not receive prophylactic antibiotics as compared to 2 (13%) in the treated group. The overall rate of serious obstetrical complication was significantly higher in the untreated group (66 vs. 20%; p = 0. 021). Patients receiving prophylactic antibiotics delivered at a significantly greater gestational age than those who did not receive antibiotics (34.0 +/- 3.7 vs. 31.3 +/- 1.9 weeks, respectively; p = 0.018).


CONCLUSIONS
Our study supports the use of oral prophylactic antibiotics as being effective in reducing the previously observed significant risks associated with amnioinfusion in fetal obstructive uropathy.
Feldman
B
B
Division of Reproductive Genetics, Department of Obstetrics and Gynecology, Center for Fetal Diagnosis and Therapy, Hutzel Hospital, Detroit, Mich., USA.
Hassan
S
S
Kramer
R L
RL
Kasperski
S B
SB
Evans
M I
MI
Johnson
M P
MP
D000650:Amnion; D019072:Antibiotic Prophylaxis; D006801:Humans; D007267:Injections / Q000009:adverse effects; D016104:Oligohydramnios / Q000000981:diagnostic imaging / Q000628:therapy*; D012965:Sodium Chloride / Q000008:administration & dosage; D012996:Solutions / Q000008:administration & dosage; D016216:Ultrasonography, Prenatal; D014524:Urethral Obstruction; D014551:Urinary Tract / Q000002:abnormalities / Q000000981:diagnostic imaging*
D012996:Solutions; D012965:Sodium Chloride