Amnioinfusion for preventing puerperal infection. A prospective study

Abstract

Objective: To evaluate the hypothesis that irrigation of the uterine cavity by amnioinfusion in women with membranes ruptured for greater than six hours would decrease maternal puerperal infection.

Study design: We designed a prospective study at three teaching institutions. Sixty-eight women were randomized to receive either amnioinfusion or routine care. Amnioinfusion was through preexisting internal uterine pressure catheters with a 300-500-mL bolus and a 125-150 mL/h constant drip. Chorioamnionitis and endometritis were evaluated as the outcome variables.

Results: Women from the amnioinfusion group, n = 36, and the control group, n = 32, had similar times in labor (mean 4 hours), times of ruptured membranes (mean 18 hours), vaginal examinations (mean 7), gestational age (mean 40 weeks), types of anesthesia and methods of delivery. Women who received amnioinfusion had significantly less puerperal infection, 9/36, as compared to women in the control group, 16/32 (P < .033, relative risk = .5, confidence interval .26-.94). There were no cases of neonatal sepsis in either group, and there were no complications from the amnioinfusions.

Conclusion: In this study of women at high risk for puerperal infection, amnioinfusion was an inexpensive and safe technique for reducing the incidence of infection.