AMNIOINFUSION IN WOMEN WITH PREVIOUS CESAREAN BIRTHS - A PRELIMINARY-REPORT

OBJECTIVE: Our purpose was to evaluate the use of intrapartum amnioinf usion in women undergoing a trial of labor after a previous cesarean d elivery. STUDY DESIGN: Labor and delivery records of women undergoing intrapartum amnioinfusion over a 1-year period were reviewed retrospec tively. Neonatal data were obtained by chart review. RESULTS: During t he study period 936 women underwent intrapartum amnioinfusion for the following indications: oligohydramnios (76.6%), meconium-stained amnio tic fluid (12.8%), and variable decelerations (7.5%). Among these, 122 (13%) had previous cesarean births. Seventy-one (58.2%) women were de livered vaginally; the remaining 51 (41.8%) were delivered by repeat c esarean. Among women undergoing intrapartum amnioinfusion there were n o statistically significant differences Co < 0.05) between those with previous cesarean births and those with unscarred uteri with respect t o the following: cesarean section for fetal distress (1.6% vs 1.4%), m econium aspiration (0% vs 0.9%), or low 5-minute Apgar scores (2.5% vs 0.9%). There were no perinatal or maternal deaths in either group. On e uterine rupture occurred in a woman with one previous cesarean birth .CONCLUSIONS: Amnioinfusion appears to be an acceptable procedure in w omen with previous cesarean births. The incidence of uterine rupture ( 0.8%) noted was similar to the 10-year institutional rate at Los Angel es County-University of Southern California Women's Hospital (0.7%).