Transcervical intrapartum amnioinfusion for preterm premature rupture of the membranes.
OBJECTIVE
To investigate the effect of transcervical amnioinfusion on the management of labour and neonatal outcomes in preterm premature rupture of the membranes.


METHODS
This clinical trial included 86 patients with premature rupture of the membranes between weeks 27 and 35 of gestation. Patients were randomly assigned to receive amnioinfusion via a two-way catheter or to the control group. Clinical management was otherwise the same in both groups.


RESULTS
Amnioinfusion decreased the frequency of variable decelerations in fetal heart rate (27.9% versus 53.5%, p<0.05) and the rate of obstetric interventions motivated by nonreassuring fetal status (13.6% versus 52.4%, p<0.05). At delivery, pH values were significantly higher in the treatment group than in the conventionally managed control group (median 7.29 versus 7.27).


CONCLUSIONS
Intrapartum transcervical amnioinfusion for preterm premature rupture of the membranes reduced the number of interventions needed because of nonreassuring fetal status, and improved neonatal gasometric values without increasing maternal or fetal morbidity.
Puertas
Alberto
A
Obstetrics and Gynaecology Service, Virgen de las Nieves University Hospital, Avenida Fuerzas Armadas s/n, 18014 Granada, Spain. Electronic address: albertom.puertas.sspa@juntadeandalucia.es.
Tirado
Pilar
P
Obstetrics and Gynaecology Service, Virgen de las Nieves University Hospital, Avenida Fuerzas Armadas s/n, 18014 Granada, Spain.
Pérez
Isabel
I
Obstetrics and Gynaecology Service, Virgen de las Nieves University Hospital, Avenida Fuerzas Armadas s/n, 18014 Granada, Spain.
López
María S
MS
Obstetrics and Gynaecology Service, Virgen de las Nieves University Hospital, Avenida Fuerzas Armadas s/n, 18014 Granada, Spain.
Montoya
Francisco
F
Obstetrics and Gynaecology Service, Virgen de las Nieves University Hospital, Avenida Fuerzas Armadas s/n, 18014 Granada, Spain.
Cañizares
José M
JM
Obstetrics and Gynaecology Service, Virgen de las Nieves University Hospital, Avenida Fuerzas Armadas s/n, 18014 Granada, Spain.
Miranda
José A
JA
Obstetrics and Gynaecology Service, Virgen de las Nieves University Hospital, Avenida Fuerzas Armadas s/n, 18014 Granada, Spain.
D000136:Acid-Base Equilibrium / Q000502:physiology; D000328:Adult; D000650:Amnion / Q000503:physiopathology; D000653:Amniotic Fluid / Q000502:physiology*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000503:physiopathology / Q000628:therapy*; D005333:Fetus / Q000502:physiology; D006340:Heart Rate, Fetal / Q000502:physiology; D006801:Humans; D007263:Infusions, Parenteral / Q000379:methods*; D007752:Obstetric Labor, Premature / Q000503:physiopathology / Q000628:therapy*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second / Q000502:physiology; D011263:Pregnancy Trimester, Third / Q000502:physiology