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Amnioinfusion for preterm rupture of membranes
1Department of Obstetrics and Gynaecology, Coronation Hospital and University of the Witwatersrand, 7 York Road, Parktown 2193, Johannesburg, South Africa. 091just@chiron.wits.ac.za
Background:
Preterm rupture of membranes places a fetus at risk of cord compression and amnionitis. Amnioinfusion aims to prevent or relieve umbilical cord compression by infusing a solution into the uterine cavity.
Objectives:
The objective of this review was to assess the effects of amnioinfusion for preterm rupture of membranes on maternal and perinatal outcomes.
Search Strategy:
The Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register were searched.
Selection Criteria:
Randomised trials of amnioinfusion compared to no amnioinfusion in women with preterm rupture of membranes.
Data Collection And Analysis:
Eligibility and trial quality were assessed by the reviewer.
Main Results:
One trial of 66 women was included. It had some methodological flaws. No significant differences between amnioinfusion and no amnioinfusion were detected for caesarean section (relative risk 0.32, 95% confidence interval 0.07 to 1.40); low Apgar scores (relative risk 0.28, 95% confidence interval 0.03 to 2.33) or neonatal death (relative risk 0.55, 95% confidence interval 0.05 to 5.77). In the amnioinfusion group, the number of severe fetal heart rate decelerations per hour during the first stage of labour were reduced (weighted mean difference -1.20, 95% confidence interval -1.83 to -0.57). These outcomes are consistent with those found in the Cochrane review on amnioinfusion for cord compression.
Reviewer'S Conclusions:
There is not enough evidence concerning the use of amnioinfusion for preterm rupture of membranes.