Randomized trial of intermittent or continuous amnioinfusion for variable decelerations

Objective: To determine whether continuous or intermittent bolus amnioinfusion is more effective in relieving variable decelerations. Methods: Patients with repetitive variable decelerations were randomized to an intermittent bolus or continuous amnioinfusion. The intermittent bolus infusion group r...

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Bibliographic Details
Published in:	Obstetrics and gynecology (New York. 1953) Vol. 96; no. 4; pp. 571 - 574
Main Authors:	Rinehart, Brian K, Terrone, Dom A, Barrow, J.Harley, Isler, Christy M, Barrilleaux, P.Scott, Roberts, William E
Format:	Journal Article
Language:	English
Published:	New York, NY Elsevier Inc 01-10-2000 Elsevier Science
Subjects:	Adult Amniotic Fluid Biological and medical sciences Delivery. Postpartum. Lactation Female Fetal Monitoring Gynecology. Andrology. Obstetrics Heart Rate, Fetal Humans Labor, Obstetric Medical sciences Obstetrical techniques Pregnancy Sodium Chloride - administration & dosage Human Variable Pregnancy disorders Continuous Deceleration Treatment efficiency In utero Controlled delivery Randomization Bolus injection Intermittent Amniotic fluid Intracervical administration Female Influence Labour(obstetrics) Saline solution Comparative study
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Summary:	Objective: To determine whether continuous or intermittent bolus amnioinfusion is more effective in relieving variable decelerations. Methods: Patients with repetitive variable decelerations were randomized to an intermittent bolus or continuous amnioinfusion. The intermittent bolus infusion group received boluses of 500 mL of normal saline, each over 30 minutes, with boluses repeated if variable decelerations recurred. The continuous infusion group received a bolus infusion of 500 mL of normal saline over 30 minutes and then 3 mL per minute until delivery occurred. The ability of the amnioinfusion to abolish variable decelerations was analyzed, as were maternal demographic and pregnancy outcome variables. Power analysis indicated that 64 patients would be required. Results: Thirty-five patients were randomized to intermittent infusion and 30 to continuous infusion. There were no differences between groups in terms of maternal demographics, gestational age, delivery mode, neonatal outcome, median time to resolution of variable decelerations, or the number of times variable decelerations recurred. The median volume infused in the intermittent infusion group (500 mL) was significantly less than that in the continuous infusion group (905 mL, P = .003). Conclusion: Intermittent bolus amnioinfusion is as effective as continuous infusion in relieving variable decelerations in labor. Further investigation is necessary to determine whether either of these techniques is associated with increased occurrence of rare complications such as cord prolapse or uterine rupture.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 ObjectType-News-3 content type line 23
ISSN:	0029-7844 1873-233X
DOI:	10.1016/S0029-7844(00)00974-1