Is it safe to perform amnioinfusion in the presence of suspected intraamniotic infection?

To study the effect of amnioinfusion in the presence of suspected intra-amniotic infections (SII) on maternal outcomes among women delivering at term.

A retrospective cohort study was conducted at a tertiary medical center. All consecutive singleton term deliveries with SII during 2011-2019 were included. Cases where amnioinfusion was performed after the diagnosis of SII were compared to cases without amnioinfusion, matched by cervical dilation at diagnosis of SII. Maternal and obstetric adverse outcomes were compared.

After matching for cervical dilation at diagnosis of SII, the study cohort included 786 women: 62 (7.9%) women in the amnioinfusion group and 724 (92.1%) in the control group. A composite of adverse maternal outcomes occurred in 106 (13.5%) deliveries. There were no significant differences in the rates of maternal adverse outcomes between the amnioinfusion and control groups (11.0% vs 13.7%, respectively; P=0.59), including postpartum endometritis (5.0% vs 3.3%, respectively; P=0.46) and febrile morbidity (10.0% vs 6.5%, respectively; P=0.42). Neonatal blood gas outcomes and Apgar scores did not differ between groups.

The use of amnioinfusion for alleviating non-reassuring fetal heart rate in the presence of SII is safe and does not increase the rate of maternal adverse outcome.