Biochemical composition of fluids for amnioinfusion during fetoscopy.
OBJECTIVE
To evaluate which of the commercially available solutions is best suited for amnioinfusion during fetoscopy, based on resemblance with the biochemical properties of amniotic fluid.


METHODS
Amniotic fluid samples from 10 pregnancies were studied. Specimens were obtained from 5 pathologic pregnancies (of which 3 were complicated by polyhydramnios) and 5 uncomplicated pregnancies. The concentrations of sodium, potassium, chloride, bicarbonate, calcium, glucose, osmolality, pH, total protein content and albumin were determined in each sample. A literature search (PubMed, Embase) was performed to identify commercially available fluids used for amnioinfusion in clinical practice. The composition of these infusion solutions was compared to the amniotic fluid samples mentioned above.


RESULTS
We identified two different electrolyte solutions used in clinical practice for amnioinfusion. We identified four additional commercially available solutions that could potentially be used for amnioinfusion. Most of these infusion solutions differ considerably from midtrimester amniotic fluid samples both in electrolyte composition and pH, with the most striking difference in the latter.


CONCLUSIONS
Lactated Ringer's solution approximates amniotic fluid the closest for both electrolyte composition and pH. This infusion solution seems to be the most suitable choice for amnioinfusion during fetoscopy.
Adama van Scheltema
P N
PN
Fetal Diagnosis and Therapy Unit, Department of Obstetrics, Leiden University Medical Centre, Leiden, The Netherlands.
In't Anker
P S
PS
Vereecken
A
A
Vandenbussche
F P H A
FP
Deprest
J A
JA
Devlieger
R
R
D000653:Amniotic Fluid / Q000737:chemistry*; D004573:Electrolytes / Q000737:chemistry; D005260:Female; D005332:Fetoscopy / Q000379:methods*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007552:Isotonic Solutions / Q000737:chemistry*; D011097:Polygeline / Q000737:chemistry; D011247:Pregnancy; D000077325:Ringer's Lactate; D012965:Sodium Chloride / Q000737:chemistry
D004573:Electrolytes; D007552:Isotonic Solutions; D000077325:Ringer's Lactate; C028570:Ringer's acetate; D012965:Sodium Chloride; D011097:Polygeline