Amnioinfusion for preterm rupture of membranes
Abstract
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 methods
The Cochrane Pregnancy and Childbirth Group's Trials Register and the Cochrane Controlled Trials Register were searched. Date of last search: May 2001.
The search of the Cochrane Pregnancy and Childbirth Group's Trials Register was updated on 3 August 2009 and the results added to the awaiting assessment section of the review.
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.
Authors' conclusions
There is not enough evidence concerning the use of amnioinfusion for preterm rupture of membranes.
[Note: The twelve citations in the awaiting classification section of the review may alter the conclusions of the review once assessed.]
PICOs
Plain language summary
Amnioinfusion for preterm rupture of membranes
Too little evidence to show whether amnioinfusion is beneficial for babies following preterm rupture of the membranes.
The sac (membranes) surrounding the baby and fluid in the womb (uterus) usually breaks (ruptures) during labour. If the membranes rupture preterm (before 37 weeks) the baby has increased risk of infection. The chance of the umbilical cord getting compressed is also higher, which can reduce the baby's nutrients and oxygen. Extra liquid can be injected through the woman's vagina or abdomen into the womb (amnioinfusion), providing more liquid to surround the baby. The review of trials found too little evidence to show whether amnioinfusion with a salt (saline) solution is beneficial for babies following preterm rupture of the membranes.
