In Transabdominal Amnioinfusion, saline is used to replace lost amniotic fluid. It is a safe and effective way to reduce the complications of oligohydramnios. The saline is administered through the mother’s cervix or abdomen.
Amniotic Fluid (AF) is an important factor in fetal growth development. Its function includes acting as a protective barrier for the fetus, regulating temperature inside the womb, and guarding against infection. In order for AF to perform its job well, the correct volume should be maintained at all times – around 600-800ml at a time.
A decrease in amniotic fluid volume predisposes the fetus to complications such as slowed fetal growth and a higher risk for cesarean delivery. Also called Oligohydramnios, this condition may be caused by the premature rupture of membranes (PROM), maternal hypertension, or multiple pregnancies. This condition is often a cause of concern and should be addressed as soon as it is observed.
The goal of Transabdominal Amnioinfusion is to keep the amniotic fluid at the normal volume to avoid complications for the mother and the fetus. Amniotic Fluid keeps the baby “floating” inside the uterus, preventing the baby from pressing into the placenta or the umbilical cord.
However, with oligohydramnios, the fetus may compress the umbilical cord which compromises the baby’s circulatory system. An inadequate amount of fluid can also cause an infection due to a concentrated amount of meconium (fetal waste) in the womb.
A number of studies have shown that amnioinfusion relieves cord compression and meconium aspiration. In essence, Transabdominal Amnioinfusion reduces the risk for various maternal and fetal complications.
When you come in for the procedure, you will be guided by your healthcare provider every step of the way. You may be asked to change to a hospital gown then assisted to lie flat on the bed. In some cases, you and the fetus will be hooked to monitors to observe your progress throughout the procedure.
An ultrasound machine will be used to monitor the baby’s movements. It will also be used to choose an ideal spot to place the needle for the infusion. You will feel the ultrasound probe move around during the procedure – don’t worry, this is normal.
Once the doctor locates the ideal spot, it will be cleansed with Povidone-iodine. A needle will carefully be threaded through the skin, the uterus, and finally the amniotic sac. In some cases, mild contractions may occur. The fluid (normal saline or lactated ringer’s solution) will then be infused to reinforce the amniotic fluid volume. The entire procedure should last for around 1 to 2 hours.
Depending on her current physical condition, the mother may be asked to undergo routine laboratory and diagnostic tests prior to the procedure. If she is on any type of blood thinners such as aspirin, it should be discontinued a day before your appointment. Your doctor will guide you through this process to make sure you’re all set.
Most women are allowed to return home after amnioinfusion. Pain medications and muscle relaxants may be prescribed depending on your care plan. Doctors recommend avoiding any strenuous activity 1-2 days after the procedure. These activities include exercise, excessive walking, or lifting heavy objects.
An ultrasound machine is present during the entire procedure to closely monitor the amount of fluid being administered into the uterus. This is done in order to prevent a condition called Hydramnios or having an excessive amount of amniotic fluid. Other fetal complications that may arise include cord prolapse, increased intrauterine pressure, and uterine infection.
In some cases, the mother may experience vaginal bleeding or amniotic fluid may leak through the vagina. Mild contractions are also expected a few hours after the procedure. However, should be bleeding or the contractions become troublesome, please seek medical attention immediately.
What are the contraindications for this procedure?
While Transabdominal Amnioinfusion is a relatively common procedure, there are some cases in which it cannot be recommended. Multiple pregnancies, unstable fetus, fetus with anatomical anomalies, and chorioamnionitis (bacteria infection in the amniotic fluid or in the membranes surrounding the fetus) are examples of conditions that aren’t compatible with amnioinfusion.
Can I travel after the procedure?
Mothers are advised to stay at home for at least 7 days after the procedure.
What complications may occur if this procedure is not performed?
A decreased volume of amniotic fluid has detrimental consequences for both mother and fetus. Premature labor, cord compression, infection, and fetal demise are just some conditions that may arise if the problem is not rectified immediately.
What is premature rupture of membrane?
Premature Rupture of Membranes (PROM) is a condition wherein the amniotic sac breaks before the pregnancy comes to term. It is considered as a medical emergency because it puts both the mother and the fetus in jeopardy. Symptoms include a sudden gush of fluid leaking from the vagina. Premature delivery, infection, and fetal death may result from this condition.