Prophylactic versus therapeutic amnioinfusion for oligohydramnios in labour.
BACKGROUND
Amnioinfusion aims to relieve umbilical cord compression during labour by infusing a liquid into the uterine cavity.


OBJECTIVE
The objective of this review was to assess the effects of prophylactic amnioinfusion for oligohydramnios compared with therapeutic amnioinfusion only if fetal heart rate decelerations or thick meconium-staining of the liquor occur.


METHODS
The Cochrane Pregnancy and Childbirth Group trials register and Cochrane Controlled Trials Register were searched. Date of last search: October 1997.


METHODS
Randomised trials comparing prophylactic with therapeutic amnioinfusion in women with oligohydramnios but not fetal heart rate deceleration in labour.


METHODS
The reviewer assessed trial quality and extracted data.


RESULTS
Two studies of 285 women were included. No differences were found in the rate of caesarean section (relative risk 0.98, 95% confidence interval 0.58 to 1.66), or forceps delivery. There were no difference in Apgar scores, cord arterial pH, oxytocin augmentation, meconium aspiration, neonatal pneumonia or postpartum endometritis. Prophylactic amnioinfusion was associated with increased intrapartum fever (relative risk 3.48, 95% confidence interval 1.21 to 10.05).


CONCLUSIONS
There appears to be no advantage of prophylactic amnioinfusion over therapeutic amnioinfusion carried out only when fetal heart rate decelerations or thick meconium-staining of the liquor occur.
Hofmeyr
G J
GJ
Department of Obstetrics and Gynaecology, Coronation Hospital and University of the Witwatersrand, 7 York Road, Parktown 2193, Johannesburg, South Africa. 091just@chiron.wits.ac.za
D000650:Amnion; D005260:Female; D006801:Humans; D007267:Injections; D007744:Obstetric Labor Complications / Q000517:prevention & control / Q000628:therapy; D016104:Oligohydramnios / Q000517:prevention & control / Q000628:therapy; D011247:Pregnancy