Prophylactic versus therapeutic amnioinfusion for oligohydramnios in labour.

BACKGROUND: Amnioinfusion aims to relieve umbilical cord compression during labour by infusing a liquid into the uterine cavity.

OBJECTIVES: The objective of this review was to assess the effects of prophylactic amnioinfusion for oligohydramnios compared with therapeutic amnioinfusion only if fetal heart rate decelerations or thick meconium-staining of the liquor occur.

SEARCH STRATEGY: The Cochrane Pregnancy and Childbirth Group trials register and Cochrane Controlled Trials Register were searched. Date of last search: October 1997.

SELECTION CRITERIA: Randomised trials comparing prophylactic with therapeutic amnioinfusion in women with oligohydramnios but not fetal heart rate deceleration in labour.

DATA COLLECTION AND ANALYSIS: The reviewer assessed trial quality and extracted data.

MAIN RESULTS: Two studies of 285 women were included. No differences were found in the rate of caesarean section (relative risk 0.98, 95% confidence interval 0.58 to 1.66), or forceps delivery. There were no difference in Apgar scores, cord arterial pH, oxytocin augmentation, meconium aspiration, neonatal pneumonia or postpartum endometritis. Prophylactic amnioinfusion was associated with increased intrapartum fever (relative risk 3.48, 95% confidence interval 1.21 to 10.05).

REVIEWER'S CONCLUSIONS: There appears to be no advantage of prophylactic amnioinfusion over therapeutic amnioinfusion carried out only when fetal heart rate decelerations or thick meconium-staining of the liquor occur.