Antenatal transabdominal amnio‐infusion for oligo‐hydramnios due to preterm premature rupture of membranes

Abstract

A reduction in the amount of amniotic fluid occurs in 3–5% of all deliveries. This could be due to congenital anomalies, IUGR or premature rupture of membranes. Preterm rupture of membranes places the fetus at risk of cord compression and amnionitis. On the other hand, oligo‐hydramnios has been associated with severe pulmonary hypoplasia. In 1983, Miyazaki and Nevarez first reported the effectiveness of intrauterine installation of saline solutions in relieving variable decelerations during labor. Since then, amnio‐infusion has aroused interest. To our knowledge, there has been no conclusive study done to evaluate the use of antenatal amnio‐infusion for oligo‐hydramnios diagnosed antenatally. We would like to present three case‐studies of oligo‐hydramnios seen in our department in the period 1997–2001 which we performed antenatal transabdominal amnio‐infusion. Warm saline/Hartmann solution was injected through a 22G spinal needle under ultrasound guidance. Vaginal delivery occurred in two cases (one term and one preterm); the third pregnancy is still on‐going. There was no meconium aspiration and no signs of fetal distress. Both cases had good maternal and neonatal outcome except that the preterm baby was treated with intravenous ampicillin/gentamicin for pneumonia. There was no congenital malformation noted.