EJMS

Abstract

Objectives: To evaluate maternal and fetal outcome after trans-cervical amnioinfusion for women presenting by premature rupture of membranes after 37 gestational weeks. Patients & Methods: 98 women were evaluated using amniotic fluid index (AFI), fetal heart rate (FHR) monitoring using continuous cardiotopography (CTG) and biophysical profile score (BPS). Patients showed AFI >5, 8-10 BPS and CTG showed no or variable decelerations with no concern characteristics for <90 min were randomly divided into two groups: Group A received only conventional management and Group B received conventional management plus amnioinfusion. Study outcomes included frequency of cesarean section (CS), assisted vaginal delivery, stoppage of amnioinfusion either for development of tetanic contraction or fetal distress. One and five minute APGAR score, the frequency of NICU admission and its indications and fetal mortality rate. Results: 27 women in group A and 15 in group B had CS with significantly lower frequency in group B. Eighteen women had CS for fetal distress during progress of labor, 17 women for failure of labor progress and 7 women in group B for fetal distress secondary to development of tetanic contraction with significant difference in favor of amnioinfusion. The frequency of assisted vaginal delivery was significantly lower in group B than in group A. Amnioinfusion significantly improved neonatal outcome as manifested by significantly higher frequency of neonates had 1-min APGAR score of >7 and higher mean APGAR score, significant reduction of frequency and severity of birth asphyxia and non-significantly lower frequency of NICU admission. Conclusion: Amnioinfusion is a safe and feasible management policy for women had premature rupture of membranes. It significantly reduced the need for CS and increased the chance for getting unassisted vaginal delivery. Also, amnioinfusion improved neonatal outcome with significant improvement of FHR and reduced its variable decelerations and reduced frequency and severity of neonatal asphyxia.