The use of amnioinfusion in nurse-midwifery practice

Intrapartum amnioinfusion is being used in a variety of clinical settings and for multiple therapeutic modalities to prevent fetal distress and improve outcomes. The procedure has demonstrated efficacy in cases of variable decelerations and thick, meconium-stained amniotic fluid. Amnioinfusion has been shown to improve maternal and neonatal outcomes by decreasing cesarean sections for fetal distress, improving cord pH, and decreasing the amount of meconium present below the cords at delivery. This article describes the pathophysiology of amniotic fluid volume disorders that indicate the use of amnioinfusion, reviews the literature regarding the indications and therapeutic effects, and describes techniques for the use of amnioinfusion. In addition, there is a discussion of the contraindications associated with the use of amnioinfusion and its use in and out of hospital settings. The technique for amnioinfusion is simple, easy, and inexpensive to initiate. It can be performed in a variety of settings, provided there is adequate equipment, personnel, and emergency services available. Certified nurse-midwives should become familiar and comfortable with the procedure in order to provide complete care for the families they serve.