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Amnioinfusion
- Indications
- Oligohydramnios with or without Fetal Distress
- Preterm prolonged Rupture of Membranes
- Recurrent Variable Decelerations
- Cephalic presentation
- Thick particulate Meconium staining of amniotic fluid
- Oligohydramnios with or without Fetal Distress
- Contraindication
- Amnioinfusion should not delay definitive management
- Chorioamnionitis
- Fetal Malpresentation (e.g. Breech, Transverse Lie)
- Scalp pH < 7.20
- Late Decelerations
- Multiple Gestation
- Uterine anomaly
- Undiagnosed Third Trimester Bleeding
- Placental Abruption
- Placenta Previa
- Efficacy
- Heavy meconium stained fluid
- Improved perinatal outcome
- Reduced risk Meconium Aspiration Syndrome
- Decreased NICU admissions
- Decreased risk of Mechanical Ventilation
- Cord Compression suspected
- Reduces FHR Variable Decelerations
- Lowers rate of ceserean sections
- Heavy meconium stained fluid
- Technique
- Cervical exam
- Evaluate dilation and presentation
- Evaluate for Umbilical Cord Prolapse
- Place fetal scalp electrode
- Place double lumen intrauterine pressure catheter
- Initial Bolus
- Warmed normal saline at 10-20 ml/minute
- Stop bolus at 250 to 500 cc
- Maintenance infusion of warmed normal saline
- Rate: 3 cc/min or 50 to 60 cc/hour
- Document intrauterine pressure continuously
- Goal: Maintain amniotic fluid index of 8-12 cm
- Cervical exam
- Adverse Effects
- Umbilical Cord Prolapse
- Uterine scar rupture
- Amniotic Fluid Embolism
- References
Amnioinfusion (C0262671) | |
|---|---|
| Concepts | Therapeutic or Preventive Procedure (T061) |
| ICD9 | 75.37 |
| English | Amnioinfusion |
| Spanish | amnioinfusion |
| Parent Concepts | Other intrauterine operations on fetus and amnion (C0177283), Infusion procedures (C0574032), Procedure on organ (C1292895) |
| Sources | ICD9CM, SCTSPA, SNOMEDCT Derived from the NIH UMLS (Unified Medical Language System) |
