RESUMO
Amnioinfusion was performed in a prospective, randomized trial of 60 women in the latent phase of labor with oligohydramnios, as defined by an amniotic fluid index less than or equal to 5.0 cm. All fetuses were at least 37 weeks' gestational age, had normal baseline fetal heart rate variability, and no clinically significant fetal heart rate decelerations at the outset. Subjects in the amnioinfusion group (n = 30) were titrated to and maintained at an amniotic fluid index level greater than or equal to 8.0 cm throughout labor. In the group receiving amnioinfusion, significantly lower rates of meconium passage (p = 0.04), severe variable decelerations (p = 0.04), end-stage bradycardia (p = 0.05), and operative delivery for fetal distress (p = 0.002) occurred. Significantly higher umbilical arterial blood pH values were also noted in the infusion group (p = 0.02). We conclude that prophylactic intrapartum amnioinfusion is an important technique for the reduction of intrapartum morbidity.
Assuntos
Âmnio , Líquido Amniótico/fisiologia , Sofrimento Fetal/prevenção & controle , Complicações do Trabalho de Parto/terapia , Adolescente , Adulto , Feminino , Frequência Cardíaca Fetal , Humanos , Infusões Parenterais , Primeira Fase do Trabalho de Parto , Gravidez , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
Amnioinfusion of 250 ml of normal saline solution was performed in 30 laboring women at greater than or equal to 37 weeks' gestation with oligohydramnios as defined by an amniotic fluid index of less than or equal to 5 cm. A total of 50 amnioinfusions were performed. Amniotic fluid volumes, as assessed by the amniotic fluid index, increased by a mean of 4.3 +/- 1.5 cm after infusion. We conclude that in women with oligohydramnios, 250 ml of amnioinfusate will increase the amniotic fluid index by approximately 4 cm.
