Background: The objective was to estimate the effect of intrapartum
amnioinfusion (AI) for recurrent variable decelerations on neonatal morbidity.
The primary outcome was composite neonatal neurologic morbidity assembled from
individual neonatal outcomes used clinically with suspected hypoxic-ischemic
encephalopathy (HIE). Secondary outcomes were composite neonatal morbidity not
associated with HIE. Methods: Data Sources: A predefined,
systematic search was conducted through Ovid Medline, Embase, CINAHL PLUS,
Cochrane library (including CENTRAL), Scopus, and Clinicaltrials.gov and was used
to identify studies assessing the relationship between intrapartum AI and
neonatal morbidity yielding 345 unique citations from 1982 to 2018. Study
Eligibility Criteria: Randomized control trials that compared intrapartum AI to
no AI for recurrent variable decelerations and included neonatal outcomes were
included. Randomized trials comparing AI for other indications (e.g., meconium
aspiration syndrome) were excluded, as were studies on intrapartum AI that lacked
a control group (i.e., no amnioinfusion). Results: A total of 3
randomized control trials met the selection criteria. Outcomes from 282 neonates
exposed to intrapartum AI for recurrent variable decelerations were compared to
those from 286 who had fetal monitoring with recurrent variable decelerations but
did not receive AI. There were no data on neonatal neurologic morbidity outcomes
related to HIE. Among the data available, composite neonatal morbidity was not
significantly different with AI (28.7% vs. 59.1%, pooled risk ratio,
–0.30; 95% CI (95% confidence interval) –0.99–0.40; I
Announcements
Open Access
Systematic Review
Intrapartum Amnioinfusion for Recurrent Variable Decelerations and Neonatal Morbidity: A Systematic Review and Meta-Analysis
Brock E. Polnaszek1,*, Julia Rossen1, Katherine H. Bligard2, Angela Hardi2, Emily S. Miller1, Methodius G. Tuuli1, Adam K. Lewkowitz1
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1
Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine and Women and Infants Hospital of Rhode Island, Warren Alpert Medical School of Brown University, Providence, RI 02905, USA
2
Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Washington University in Saint Louis, Saint Louis, MO 63110, USA
*Correspondence: brock.polnaszek@gmail.com (Brock E. Polnaszek)
Clin. Exp. Obstet. Gynecol. 2024, 51(3), 75;
https://doi.org/10.31083/j.ceog5103075
Submitted: 29 November 2023 | Revised: 20 December 2023 | Accepted: 30 December 2023 | Published: 18 March 2024
Copyright: © 2024 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract
Keywords
amnioinfusion
labor
intrapartum
recurrent variable decelerations
neonatal morbidity
neurologic morbidity
Funding
Foundation for Society of Maternal Fetal Medicine 2022 Danielle Peress MD Memorial Fund
#9595/Gerber Foundation Research Novice
Figures
Fig. 1.