Amnioinfusion...pump or no pump???

[USA987]

Our guidelines were recently updated stating amnioinfusions must be on a pump. Just curious as to what everyone else is doing????

[CarsonRNC]

Could you please forward the references for the use of the pump for amnioinfusions? We currently use them, but a new physician wants to not use the pumps. I need data or evidence based data to present to him.

Thank you

Carson

[MalgaBSN]

From 2008 Perinatal Nursing Text:

Amnioinfusion has been shown to resolve patterns of variable decels, but not late decels or decreased variability. Amnioinfusion for oligiohydramnios is not necessary and does not seem to prevent variable decels. In a recent large study, amnioinfusion did NOT reduce risk of moderate or severe meconium aspiration syndrome or perinatal death. Based on available evidence, amnioinfusion should be limited to treatment of variable decels.

Procedure according to the awhonn recommendations in their Perinatal book: Room temp NS or LR is infused into the uterus via IUPC. Initial bolus is 250-500 ml given over 20-30 min using either infusion pump or gravity flow. Both methods are appropriate and seem to be equally efficacious (ACOG, 2006a). It then goes on to explain a continuous infusion ratio and how to check for return.