What is the role of amnioinfusion in modern day obstetrics?

Dad, Nimra; Abushama, Mandy; Konje, Justin C.; Ahmed, Badreldeen

doi:10.3109/14767058.2015.1105953

Cited by 9 publications

(7 citation statements)

References 19 publications

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“…• Fetal vesicostomy using open maternal-fetal or endoscopic approach with amnioinfusion (Table 3, [15,[48][49][50][51][52][53]). • Amnioinfusion has been proposed for an improved ultrasound diagnostic opportunity with second trimester and/or oligohydramnios secondary to bladder neck obstruction and to allow fetal access for VAS or FC [54][55][56][57][58]. • Neonatal evaluation with cystoscopy is required for all fetal therapy survivors to confirm pathology and initiate additional treatment as required.…”

Section: Results/interventions: Identification Of Potential Evidenced-based Protocol Elements For Development Of An Eras-luto Guidelinementioning

confidence: 99%

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Evaluation of the Fetal Therapy Evidence in Lower Urinary Tract Obstruction: Would an ERAS Guideline Improve Outcomes?

Wilson¹,

Nelson²

2021

Fetal Diagn Ther

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Background: Pregnancies that are prenatally identified to have fetal anomalies are complex and require expert multidisciplinary care. As many conditions can impact the fetus prenatally and require intervention, an enhanced recovery after surgery (ERAS) for lower urinary tract obstruction (LUTO) is being evaluated to determine the level of evidenced-based data available. Problem: The percutaneous ultrasound-guided fetal surgery procedure for bladder neck obstruction is the focus for elements of preoperative counseling, intraoperative procedure/risk complications, and postoperative management. Methods: A quality improvement review Squire 2.0 (2000–2020) was undertaken for the percutaneous LUTO fetal surgery shunting (lower urinary tract obstruction), process and procedure which require 2 process pathways, one to evaluate the fetal candidate and a second to treat. This structured review is focused on identifying the process elements to allow the determination of the number of evidenced-based elements that would allow for audit and measurement of the clinical element variance for comparative feedback to the individual surgical provider or surgery center. Interventions: Titles and abstracts were screened to identify potentially relevant articles with priority given to meta-analyses, systematic reviews, randomized controlled studies, nonrandomized controlled studies, reviews, and case series. Results: A series of potential clinical elements for the diagnostic fetal evaluation and for the 3 protocol areas of surgical care for the procedures (pre-, intra-, and postoperative care) are identified using an ERAS-like process. Conclusions: The identified clinical elements have the potential for ERAS-LUTO fetal therapy guideline. Multidisciplinary collaboration (surgeon, anesthesia, nursing, imaging, and laboratory) is required for ERAS quality improvement in the pre-, intra-, and postoperative processes. Process elements in each of the operative areas can be audited, evaluated, compared, and modified/improved.

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Section: Results/interventions: Identification Of Potential Evidenced-based Protocol Elements For Development Of An Eras-luto Guidelinementioning

confidence: 99%

“…Amnio-infusion have been used therapeutically to correct clinical anhydramnios/oligohydramnios secondary to idiopathic, renal, or premature rupture of membrane etiologies or diagnostically to enhance ultrasound visualization with severe oligohydramnios [54][55][56][57][58].…”

Section: Maternal/fetal Risk and Complicationsmentioning

confidence: 99%

Evaluation of the Fetal Therapy Evidence in Lower Urinary Tract Obstruction: Would an ERAS Guideline Improve Outcomes?

Wilson¹,

Nelson²

2021

Fetal Diagn Ther

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“…Amnioinfusion (AI) is effective for the treatment of variable decelerations in the first stage of labor [1,2]. It is also considered effective for the treatment of umbilical cord compression in fetal growth restriction with oligohydramnios [3], idiopathic oligohydramnios [4], or um-Biomed Hub 2021;6:86-91 DOI: 10.1159/000519084 bilical cord compression without oligohydramnios [5] during pregnancy.…”

Section: Introductionmentioning

confidence: 99%

“…It is also considered effective for the treatment of umbilical cord compression in fetal growth restriction with oligohydramnios [3], idiopathic oligohydramnios [4], or um-Biomed Hub 2021;6:86-91 DOI: 10.1159/000519084 bilical cord compression without oligohydramnios [5] during pregnancy. Additionally, it is used to increase the ultrasonographic accuracy in identifying structural anomalies in patients with oligohydramnios [2,6]. Although the use of therapeutic AI during pregnancy prior to parturition has not yet been established, transabdominal AI is expected to be a new intervention for umbilical cord compression and oligohydramnios.…”

Section: Introductionmentioning

confidence: 99%

Changes in the Intra-Amniotic Pressure following Transabdominal Amnioinfusion during Pregnancy

et al. 2021

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Objective: The aim of the article was to investigate the changes in intra-amniotic pressure following transabdominal amnioinfusion during pregnancy. Design: This retrospective study included 19 pregnant women who underwent transabdominal amnioinfusion during pregnancy to relieve umbilical cord compression and improve the intrauterine environment or to increase the accuracy of ultrasonography. Materials and Methods: We measured and analyzed the changes in intra-amniotic pressure, single deepest pocket, and the amniotic fluid index before and after amnioinfusion. We also determined the incidence of maternal or fetal adverse events, such as preterm premature rupture of membranes, preterm delivery, fetal death within 48 h, placental abruption, infection, hemorrhage, and peripheral organ injury. Results: A total of 41 amnioinfusion procedures were performed for 19 patients. The median gestational age during the procedure was 24.3 weeks. The median volume of the injected amniotic fluid was 250 mL. The median single deepest pocket and amniotic fluid index after amnioinfusion were significantly higher than those before amnioinfusion (4.0 cm vs. 2.65 cm; p < 0.001 and 13.4 cm vs. 6.0 cm; p < 0.001). However, the median (range) intra-amniotic pressure after amnioinfusion was not significantly different compared to that before amnioinfusion (11 mm Hg vs. 11 mm Hg; p = 0.134). Maternal or fetal adverse events were not observed following amnioinfusion. Conclusion: Intra-amniotic pressure remained unchanged following amnioinfusion. The complications associated with increased intra-amniotic pressure are not likely to develop if the amniotic fluid index and/or single deepest pocket remains within the normal range after amnioinfusion. Studies of groups with and without complications are warranted to clarify the relationship between the intra-amniotic pressure and incidence of complications.

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“…Amniotic fluid (AF) is a dynamic medium that plays a significant role in fetal well-being as it contains antimicrobial and growth factors, and helps fetal lung growth and maturity (1) .…”

Section: …………………………………………………………………………………………………… Introduction:-mentioning

confidence: 99%

Intrapartum Trans-Cervical Amnioinfusion as Adjuvant to Conventional Management of Women Had Ruptured Membranes With Thick Meconium-Stained Amniotic Fluid.

Sherbeny¹,

B²

2017

IJAR

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What is the role of amnioinfusion in modern day obstetrics?

Cited by 9 publications

References 19 publications

Evaluation of the Fetal Therapy Evidence in Lower Urinary Tract Obstruction: Would an ERAS Guideline Improve Outcomes?

Evaluation of the Fetal Therapy Evidence in Lower Urinary Tract Obstruction: Would an ERAS Guideline Improve Outcomes?

Changes in the Intra-Amniotic Pressure following Transabdominal Amnioinfusion during Pregnancy

Intrapartum Trans-Cervical Amnioinfusion as Adjuvant to Conventional Management of Women Had Ruptured Membranes With Thick Meconium-Stained Amniotic Fluid.

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