Amnioinfusion in the evaluation of fetal obstructive uropathy: The effect of antibiotic prophylaxis on complication rates

Objective: Amnioinfusion plays an important role in the intrauterine evalua tion and treatment of fetal obstructive uropathy. However, it may significa ntly increase the risk for chorioamnionitis, premature rupture of membranes and premature labor. We evaluated the impact of prophylactic antibiotics o n postamnioinfusion complications. Methods: Thirty pregnancies complicated by fetal obstructive uropathy, treated by amnioinfusion and with documentat ion of pregnancy outcome were identified from our database. Pregnancy outco mes were compared between patients who were treated with prophylactic antib iotics and those with no prophylaxis. Results: Chorioamnionitis was diagnos ed in 3 out of 15 (20%) patients who did not receive prophylactic antibioti cs as compared to 2 (13%) in the treated group. The overall rate of serious obstetrical complication was significantly higher in the untreated group ( 66 vs. 20%; p = 0.021). Patients receiving prophylactic antibiotics deliver ed at a significantly greater gestational age than those who did not receiv e antibiotics (34.0 +/- 3.7 vs. 31.3 +/- 1.9 weeks, respectively; p = 0.018 ). Conclusions: Our study supports the use of oral prophylactic antibiotics as being effective in reducing the previously observed significant risks a ssociated with amnioinfusion in fetal obstructive uropathy.