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 strategy: The Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register were searched.

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.

Reviewer's conclusions: There is not enough evidence concerning the use of amnioinfusion for preterm rupture of membranes.