The Yield of Amnioinfusion in the Prevention of Postpartum Hemorrhage

Abstract

Objective

Although amnioinfusion decreases the rate of uterine atony, its effect on postpartum hemorrhage (PPH) is uncertain. This study aimed to assess whether amnioinfusion reduces the risk of PPH in laboring individuals.

Study Design

A retrospective study of all laboring singletons at a tertiary center between January 2013 and December 2022 at ≥34 weeks. Individuals with known major fetal anomalies, stillbirths, or missing delivery records were excluded. The primary outcome was PPH. Neonatal and secondary maternal outcomes were also explored. Adjusted odds ratios (aOR) were estimated using multivariable regression models.

Results

Out of 113,816 deliveries during the study period, 83,152 (77.1%) met inclusion criteria, and among them 4,597 (4.03%) had amnioinfusion. Laboring individuals with amnioinfusion were more commonly nulliparous, had more polyhydramnios, oligohydramnios, preeclampsia, gestational diabetes, and fetal growth restriction. Furthermore, individuals with amnioinfusion had a higher rate of labor induction (54.54 vs. 27.8%; p < 0.01) and a higher cesarean rate (36.9 vs. 9.5%; p < 0.01). Following multivariable regression, there was no significant difference in the rate of PPH among individuals who had an amnioinfusion (2.6%) versus those who did not (3.1%; aOR: 0.95, 95% confidence interval [CI]: 0.87, 1.27). The rates of endometritis (aOR: 1.4; 95% CI: 1.04–1.89) and postpartum fever (aOR: 1.70; 95% CI: 1.36–2.12) were higher in those who had amnioinfusion compared with those that did not.

Conclusion

Among laboring individuals ≥ 34 weeks, intrapartum amnioinfusion was not associated with a reduction in the rate of PPH and was associated with a higher likelihood of infectious morbidity.

Key Points

• PPH stands as the foremost contributor to maternal mortality.

• There is limited information regarding the yield of amnioinfusion in the reduction of PPH.

• We evaluate whether amnioinfusion reduces the rate of PPH in laboring individuals ≥ 34 weeks.

Keywords

amnioinfusion - postpartum hemorrhage - endometritis - postpartum fever

Note

This study was presented as a poster presentation at the Annual Scientific Meeting of the Society for Maternal–Fetal Medicine in Maryland on February 10, 2024.

Publikationsverlauf

Eingereicht: 07. Dezember 2024

Angenommen: 09. Februar 2025

Accepted Manuscript online:
10. Februar 2025

Artikel online veröffentlicht:
18. März 2025

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