AMNIOINFUSION - DOES THE CHOICE OF SOLUTION ADVERSELY AFFECT NEONATALELECTROLYTE BALANCE

Objective: To determine whether various solutions commonly used in amn ioinfusion during labor affect neonatal electrolyte and blood gas valu es. Methods: Amnioinfusion for thick meconium or severe variable fetal heart rate decelerations is used at our institution according to a st andardized protocol. During alternating 3-week periods, the only solut ion made available for amnioinfusion was either normal saline or Ringe r's lactate. Bolus volume, rate, and duration of infusion were determi ned by the individual physicians. At delivery, cord blood was collecte d for electrolyte and blood gas determination. These values were compa red between the two solution groups and to a non-infused control group . Results: Complete data on neonatal electrolytes and blood gas values were available on 53 infusion patients (20 Ringer's lactate, 33 norma l saline) and 39 non-infusion patients. Comparing infusion to non-infu sion patients and those infused with Ringer's lactate to those with no rmal saline, we found no significant difference in demographics, neona tal outcome variables, duration of label, neonatal electrolytes, and c ord blood gas values. Infusion variables (bolus volume, infusion rate, hours infused, and total volume infused) did not differ between solut ions. Total volume and hours of infusion were closely correlated with each other (r = 0.93, P < .001); both were correlated with neonatal ch loride (r = 0.38 and r = 0.36, respectively; P < .005). No cases of hy pernatremia or hyperchloremia were found in any of the groups. The typ e of solution used had no effect on the neonatal chloride trend. Concl usion: The use of both normal saline and Ringer's lactate for indicate d amnioinfusion in labor appears to have no clinically significant eff ect on neonatal electrolytes.