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Amnioinfusion  


Amnioinfusion is a procedure in which normal saline or lactated Ringer's solution is placed into the uterus after sufficient cervical opening and rupture of membranes. Amnioinfusion can treat problems associated with decreased intra-amniotic volume, including: prophylactic treatment of oligohydramnios, treatment of severe variable decelerations during labor, and to reduce the risk of meconium aspiration during labor in patients with moderate or thick meconium fluid. Amnioinfusion is, therefore, performed during intense situations and the benefits often outweigh the risks.

What equipment is used to perform an amnioinfusion? The procedure involves a single or double lumen IUPC or intrauterine pressure catheter. The IUPC, also designed to more accurately monitor uterine contractions, also contains a port from which the saline is injected through the tubing and into the uterus.

According to the World Health Organization, "Amnioinfusion during labor for treatment of cord compression is effective in correcting fetal heart rate (FHR) abnormalities, Apgar scores (fewer babies with low Apgar), birth asphyxia and lowering caesarean section rates (when indication for caesarean section is based on FHR criteria alone), but safety of amnioinfusion concerning rare but serious maternal complications is not established. Amnioinfusion during labour when moderate or thick meconium is noted is effective in reducing the incidence of meconium found below the vocal cords, meconium aspiration syndrome and caesarean section rate, but safety of amnioinfusion concerning rare but serious maternal complications is not established."

What is Meconium Apiration Syndrome (MAS)? MAS is defined as the presence of any meconium below the level of the vocal cords. Most clinical definitions include the presence of meconium-stained amniotic fluid, aspiration of meconium from below the vocal cords (i.e., from somewhere in the tracheo-bronchial tree), and (3) a chest x-ray indicating MAS. Typically, the babies are post-mature and show signs of weight loss and yellow-stained nails, skin, and cord.




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