Indication of amnioinfusion is:a) Oligohydramniosb) Suspected renal anomaliesc) To facilitate labourd) In case of fetal distress
Correct Answer: abd
Description: Amnioinfusion is the technique to increase the intrauterine fluid volume with normal saline (500 ml).
Indications are:
Williams Obs. 22/e, p 462, 23/e, p 433
Treatment of variable or prolonged deceleration (i.e., fetal distress).
Prophylaxis for cases of known oligohydramnios as with prolonged rupture of membrane.
In an attempt to dilute or wash out thick meconium.
Besides the above mentioned therapeutic indications it can be used for diagnosis of:
Renal agenesis
PROM (Premature rupture of membrane)
Fernando Arias 3/e, p 94
“Amnioinfusion in patients with oligohydramnios is not a simple procedure. The needle should be advanced slowly with continuous ultrasound visualization and when its tip has reached the interface between the fetus and the membranes warmed saline solution should be infused.
In majority of cases, 250-350 ml of saline solution will be necessary to achieve optimal ultrasound transmission and perform a careful level II examination. A normal fetus will swallow the infused fluid, and its bladder will be easily seen with ultrasound after 20 minutes. The bladder will not be seen in fetuses with renal agenesis.
Before ending the amnioinfusion, 1 ml of indigo carmine is injected inside the amniotic sac. The patient is instructed to wear a tampon for a few hours following the procedure and observe for evidence of blue discoloration. This finding will confirm the presence of PROM.”
Fernando Arias 3/e, p 94
Category:
Gynaecology & Obstetrics
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