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Am J Perinatol 2021; 38(03): 212-217
DOI: 10.1055/s-0040-1715558
SMFM Fellowship Series Article

Intraamniotic Infection Rates after Intrauterine Pressure Catheter with and without Amnioinfusion

Neggin Mokhtari
1   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, District of Columbia
,
Tiffany Wang
2   Department of Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, District of Columbia
,
Alison DiSciullo
2   Department of Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, District of Columbia
,
Sara N. Iqbal
1   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, District of Columbia
,
Tetsuya Kawakita 
1   Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, MedStar Washington Hospital Center, Washington, District of Columbia
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Abstract

Objective This study aimed to examine the rates of intraamniotic infection between intrauterine pressure catheter with amnioinfusion and intrauterine pressure catheter alone.

Study Design This was a retrospective cohort study of all women who had an intrauterine pressure catheter placement during labor at a tertiary referral hospital from January 2016 to June 2018. Outcomes were compared between women who had an intrauterine pressure catheter with amnioinfusion and intrauterine pressure catheter placement alone. The primary outcome was the rate of intraamniotic infection. Secondary outcomes included postpartum endometritis, postpartum hemorrhage (blood loss of ≥1,000 mL), quantitative blood loss (mL), and cesarean delivery. Multivariable logistic regression analysis was performed to calculate adjusted odds ratios (aOR) and 95% confidence interval (95% CI), controlling for age, race, body mass index, gestational age, and length of time of rupture of membranes.

Results Of 1,268 women with an intrauterine pressure catheter, 298 (23.5%) also had an amnioinfusion. Women who had amnioinfusion through an intrauterine pressure catheter compared with those who had intrauterine pressure catheter alone had similar rates of intraamniotic infection (5.4 vs. 8.0%, crude p = 0.12, aOR 0.69; 95% CI 0.39–1.21), as well as secondary outcomes such as postpartum endometritis (3.0 vs. 2.5%, crude p = 0.61, aOR 1.12; 95% CI 0.49–2.53), postpartum hemorrhage (16.1 vs. 15.8%, crude p = 0.89, aOR 1.07; 95% CI 0.75–1.54), blood loss (479.5 vs. 500 mL, adjusted p = 0.89), and cesarean delivery (40.6 vs. 43.1%, crude p = 0.45, aOR 0.90; 95% CI 0.68–1.19).

Conclusion Amnioinfusion was not associated with increased odds of intraamniotic infection compared with intrauterine pressure catheter placement alone.

Key Points

  • Amnioinfusion involves instilling fluid into the amniotic cavity to relieve variable decelerations.

  • Amnioinfusion is not associated with increased odds of chorioamnionitis compared to IUPC alone.

  • Amnioinfusion is not associated with increased odds of PPH compared to IUPC placement alone.

Keywords

amnioinfusion - intrauterine pressure catheter - intraamniotic infection - chorioamnionitis - postpartum hemorrhage

Note

The results of this study were presented as an oral and poster presentation at the SMFM 40th Annual Meeting—The Pregnancy Meeting, Grapevine, TX (February 3 to 8, 2020).




Publication History

Received: 12 May 2020

Accepted: 07 July 2020

Article published online:
13 August 2020

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