Objectives: Amnioinfusion is commonly used for the intrapartum treatment of women with pregnancy complicated by thick meconium or oligohydramnios with deep variable fetal heart rate decelerations. Its benefit in women with previous cesarean deliveries is less known. Theoretically, rapid increases in intrauterine volume would lead to a higher risk of uterine rupture.
Methods: Searches of the Cochrane Library from inception to the third quarter of 2001 and MEDLINE, 1966 to November 2001, were performed by using keywords “cesarean” and “amnioinfusion.” Search terms were expanded to maximize results. All languages were included. Review articles, editorials, and data previously published in other sites were not analyzed.
Results: Four studies were retrieved having unduplicated data describing amnioinfusion in women who were attempting a trial of labor after previous cesarean section. As the studies were of disparate types, meta-analysis was not possible.
Conclusions: The use of amnioinfusion in women with previous cesarean delivery who are undergoing a trial of labor may be a safe procedure, but confirmatory large, controlled prospective studies are needed before definitive recommendations can be made.
* Amnioinfusion is commonly used in modern obstetric practice.
* Many physicians hesitate to use it in women with a previous uterine scar.
* Review of the literature is inconclusive as to whether there is an increased risk of uterine rupture among women undergoing amnioinfusion who have had previous cesarean section.
1. Hofmeyer GJ. Amnioinfusion for meconium-stained liquor in labour (Cochrane Review). In: The Cochrane Library, Issue 3, 2001. Oxford, UK.
2. Pierce J, Gaudier FL, Sanchez-Ramos L. Intrapartum amnioinfusion for meconium-stained fluid: metananalysis of prospective clinical trials. Obstet Gynecol 2000;95:1051–1056.
3. Eriksen NL, Hostetter M, Parisi VM. Prophylactic amnioinfusion in pregnancies complicated by thick meconium. Am J Obstet Gynecol 1994;171:1026–1030.
4. Khosla AH, Sangwa K, Ahuja SD, et al. Prophylactic amnioinfusion during labor complicated by meconium. Aust N Z J Obstet Gynaecol 1997;37:294–296.
5. Wenstrom KD, Parsons MT. The prevention of meconium aspiration in labor using amnioinfusion.Obstet Gynecol 1989;73:647–651.
6. Dye T, Aubbry R, Gross S, et al. Amnioinfusion and the intrauterine prevention of meconium aspiration. Am J Obstet Gynecol 1994;171:1601–1605.
7. De Meeus JB, d'Halluin G, Bascou V, et al. Prophylactic intrapartum amnioinfusion: a controlled retrospective study of 135 cases. Eur J Obstet Gynecol Reprod Biol 1997;72:141–148.
8. Macri CJ, Schrimmer DB, Leung A, et al. Prophylactic amnioinfusion improves outcome of pregnancy complicated by thick meconium and oligohydramnios. Am J Obstet Gynecol 1992;167:117–121.
9. De Meeus JB, Magnin G, Vequeau V, et al. Prophylactic amnion infusion during labor: apropos of 195 cases. J Gynecol Obstet Biol Reprod 1997;26:610–616.
10. Hourdequin P, Kauffmann E, Gabriel R, et al. Amnio-infusion during labor: experience and review of the literature. Contracept Fertil Sex 1999;27:222–230.
11. Hofmeyer GJ. Amnioinfusion for umbilical cord compression in labour (Cochrane Review). In: The Cochrane Library, Issue 3, 2001. Oxford, UK.
12. Miyazaki FS, Nevarez F. Saline amnioinfusion for relief of repetitive variable decelerations: a prospective randomized study. Am J Obstet Gynecol 1985;153:301–306.
13. Persson-Kjerstadius N, Forsgren H, Westgren M. Intrapartum amnioinfusion in women with oligohydramniosis: a prospective randomized trial. Acta Obstet Gynecol Scand 1999;78:116–119.
14. Pitt C, Sanchez-Ramos L, Kaunitz AM, et al. Prophylactic amnioinfusion for intrapartum oligohydramnios: a meta-analysis of randomized controlled trials. Obstet Gynecol 2000;96:861–866.
15. Schrimmer DB, Macri CJ, Paul RH. Prophylactic amnioinfusion as a treatment for oligohydramnios in laboring patients: a prospective, randomized trial. Am J Obstet Gynecol 1993;168:1006–1007.
16. Kurzatkowski W, Zdrodowska J, Stojak T, et al. Efficacy of amnioinfusion in anhydramnios at term before induction of labor and newborn outcome. Ginekol Pol 2000;71:837–842.
17. Mino M, Puertas A, Miranda JA, et al. Amnioinfusion in term labor with low amniotic fluid due to rupture of membranes: a new indication. Eur J Obstet Gynecol Reprod Biol 1999;82:29–34.
18. Mino M, Puertas A, Herruzo AJ, et al. Amnioinfusion in labor induction of term pregnancies with premature rupture of membranes and low amniotic fluid. In J Gynaecol Obstet 1998;61:135–140.
19. Nageotte MPO, Bertucci L, Towers CV, et al. Prophylactic amnioinfusion in pregnancies complicated by oligohydramnios; a prospective study. Obstet Gynecol 1991;77:677–680.
20. MacGregor SN, Banzhaf WC, Silver RK, et al. A prospective, randomized evaluation of intrapartum amnioinfusion: fetal acid-base status and cesarean delivery. J Reprod Med 1991;36:69–73.
21. Chauhan SP, Rutherford SE, Hess LW, et al. Prophylactic intrapartum amnioinfusion for patients with oligohydramnios: a prospective randomized study. J Reprod Med 1992;37:817–820.
22. Ogundipe OA, Spong CY, Ross MG. Prophylactic amnioinfusion for oligohydramnios: a reevaluation.Obstet Gynecol 1994;84:544–548.
23. Hofmeyer GJ. Prophylactic versus therapeutic amnioinfusion for oligohydramnios in labour (Cochrane Review). In: The Cochrane Library, Issue 4, 2001. Oxford, UK.
24. Adair CD, Sanchez-Ramos L, Kaunitz AM, et al. A trial of labor complicated by uterine rupture following amnioinfusion. South Med J 1995;88:847–848.
25. Gimovsky ML, Bayer-Zwirello LA, Plevyak M. Fetal heart rate monitoring casebook. J Perinatol1997;17:83–86.
26. Strong TH Jr, Vega JS, O'Shaughnessy MJ, et al. Amnioinfusion among women attempting vaginal birth after cesarean delivery. Obstet Gynecol 1992;79:673–674.
27. Ouzounian JG, Miller DA, Paul RH. Amnioinfusion in women with previous cesarean births: a preliminary report. Am J Obstet Gynecol 1996;174:783–786.
28. Lydon-Rochelle M, Holt VL, Easterling TR, et al. Risk of uterine rupture during labor among women with a prior cesarean delivery. N Engl J Med 2001;345:3–8.
29. Owen J, Henson BV, Hauth JC. A prospective randomized study of saline solution amnioinfusion.Am J Obstet Gynecol 1990;162:1146–1149.
30. Moen MD, Besinger RE, Tomich PG, et al. Effect of amnioinfusion on the incidence of postpartum endometritis in patients undergoing cesarean delivery. J Reprod Med 1995;40:383–386.
31. Glantz JC, Letteney DL. Pumps and warmers during amnioinfusion: is either necessary? Obstet Gynecol 1996;87:150–155.