Aetna considers amnioinfusion medically necessary for any of the following indications. Nursing responsibilities regarding amnioinfusion include pattern recognition, assisting with or initiation of amnioinfusion, and maintenance and evaluation of this intervention. Amnioinfusion is used to increase the volume of amniotic fluid around the fetus during pregnancy. Using amnioinfusion for the relief of repetitive variable decelerations during labor using amnioinfusion for the relief of repetitive variable decelerations during labor galvan, barbara j mullem, christine. This separation would occur late in pregnancy, and accounts for 10%. Transabdominal amnioinfusion for preterm premature rupture of membranes. Author links open overlay panel judy schmidt rnc, edd. Amnioinfusion for third trimester preterm premature. Making the case for intrapartum amnioinfusion sciencedirect.
Amniopatch, a repairing technique for premature rupture of. Amnioinfusion refers to the instillation of fluid into the amniotic cavity. The sac membranes surrounding the baby and fluid in the womb uterus usually breaks ruptures during labour. Using amnioinfusion for the relief of repetitive variable decelerations during labor. Amnioinfusion is being used to treat intrapartum problems known to be associated with fetal compromise, including prophylactic treatment of oligohydramnios during labor and after premature rupture. Amnioinfusion definition of amnioinfusion by medical dictionary. Abruptio placentae also known as placental abruption is the premature separation of the placenta that occurs late in the pregnancy. Ensure that amnioinfusion solution is warmed to body temperature. Amnioinfusion is a method in which isotonic fluid is instilled into the uterine cavity it is primarily used as a treatment in order to correct fetal heart rate changes caused by umbilical cord compression, indicated by variable decelerations seen on cardiotocography. Feb 03, 2020 write down your questions so you remember to ask them during your visits. Making the case for intrapartum amnioinfusion nursing. Nursing care ensure fhr is reassuring before, underpads are in place, monitor fhr afterwards, document characteristics of fluid, and check temp q 24 hours. Other activities to help include hangman, crossword, word scramble, games, matching, quizes, and tests.
Definition alt infusing a sterile solution into a clientpatients. The combination approach is the most frequently used technique wenstrom et al. The utility of amnioinfusion in the prophylaxis of meconiumstained amniotic fluid infectious morbidity. Discontinue amnioinfusion if any of the following occur and notify physician. Started in 1995, this collection now contains 6769 interlinked topic pages divided into a tree of 31 specialty books and 732 chapters. Indications for amnioinfusion include severe variable. Cpt 2004 introduced 59070 transabdominal amnioinfusion, including ultrasound guidance as one of a series of new fetal surgery codes 5907059076. The investigators propose an open trial comparing baseline doppler waveforms in the uteroplacental and fetal pulmonary circulation in patients presenting with severe, idiopathic olighydramnios afi 14. Ask your healthcare provider if you can return to work after your procedure.
Current technology has simplified the amnioinfusion procedure. Amnioinfusion ai is typically used during the intrapartum period to supplement an inadequate amount of amniotic fluid or to dilute thick, meconiumstained fluid. Oct 16, 2012 the aim of this study was to investigate perinatal outcome and the rate of cesarean section cs following intrapartum amnioinfusion in women with meconiumstained amniotic fluid msaf. The aim of this study was to investigate perinatal outcome and the rate of cesarean section cs following intrapartum amnioinfusion in women with meconiumstained amniotic fluid msaf.
Decelerations have not been relieved after 500 cc infused. Statistical significance was defined at the twosided p0. Amnioinfusion has also been used to reduce the risk of meconium aspiration during labor in women with moderate or thick meconium fluid. If, during labor, your babys heart rate dips down below a certain level, your doctor might decide you should have an amnioinfusion. Nursing actions during amnioinfusion include providing a clear description of the equipment and procedure based on the level of sophistication of the patient. Therapeutic amnioinfusion for oligohydramnios during pregnancy excluding labour 1 guidance 1. Amnioinfusion for preterm premature rupture of membranes. Amnioinfusion labor and delivery clinical protocol running. Amnioinfusion labor and delivery clinical protocol. Amnioinfusion is a method of replacing intrauterine amniotic fluid volume through intrauterine infusion of a saline solution using a pressure catheter. Infusion of intravenous iv fluid into the uterus during labor to relieve umbilical cord compression and alleviate fetal distress from severe prolonged variable decelerations in the presence of oligohydramnios. Alterations of the uteroplacental and fetal pulmonary. Definition nic infusion of fluid into the uterus during labor to relieve umbilical cord compression or to dilute meconiumstained fluid.
Intrauterine pressure catheter iupcamnioinfusion number. Amnioinfusion is a procedure in which normal saline is infused into the uterine cavity to replace amniotic fluid. Amnioinfusion should be limited to the treatment of recurrent variable decelerations during first stage labour which have not resolved with maternal position changes. Replacing the amniotic fluid with normal saline has been found to be a safe, simple, and very effective way to reduce the occurrence of repetitive variable decelerations. However, current evidence is insufficient to recommend amnioinfusion for routine use in pprom. Amnioinfusion medical definition merriamwebster medical.
Amniocentesis discharge care what you need to know. Learn the new code s specific requirements to avoid miscodingbefore you report 59070, make sure you meet all the strict requirements associated with this code. Initiation of amnioinfusion will be ordered and performed by a certified nurse midwife. Included in the teaching plans table 1 table 1 should be a plan for discussions of the role of amniotic fluid, the function of the umbilical cord, and methods of assessing the. Amnioinfusion medical clinical policy bulletins aetna. A fetal scalp electrode is recommended but not required. Amnioinfusion definition nci the procedure of instilling saline or other fluids into the amniotic cavity using an intrauterine catheter. Fetal heart rate tone monitoring decelerations early, late, variable nclex ob maternity nursing duration. The use of amnioinfusion for potential or suspected umbilical cord compression may be of considerable benefit to mother and baby by reducing the occurrence of variable fhr decelerations, improving shortterm measures of neonatal outcome, reducing maternal postpartum endometritis and lowering the use of caesarean section, although there were methodological limitations to the trials. Any documents appearing in paper form are not controlled and should be checked against the electronic file version prior to use. Using amnioinfusion for the relief of repetitive variable. Pdf amniopatch, a repairing technique for premature rupture. It is used to treat problems known to be associated with decreased intraamniotic volume, including prophylactic treatment of oligohyramnios and treatment of fetal distress during labor. Intrapartum amnioinfusion in meconiumstained liquor.
Making the case for intrapartum amnioinfusion nursing for. Looking for online definition of amnioinfusion or what amnioinfusion stands for. In severe cases of oligohydramnios, amnioinfusion may be performed prophylactically to prevent umbilical cord compression. To outline nursing responsibilities in setting up and assisting with amnioinfusion. Dec 14, 2017 fetal heart rate tone monitoring decelerations early, late, variable nclex ob maternity nursing duration. Amnioinfusion labor and delivery clinical protocol pathophysiologyamnioinfusion is a procedure in which normal saline or lactated ringers solution is infused into the uterine cavity to replace amniotic fluid. Amnioinfusion definition of amnioinfusion by medical. Hospitalization, tocolytic therapy, and im corticosteroids correct explanation. The experience of amnioinfusion for oligohydramnios during the early second trimester. Reinforce the need for close supervision and follow up. Amniopatch, a repairing technique for premature rupture of amniotic membranes in second trimester article pdf available in acta biomedica. For some unknown reasons, it suddenly begins to separate, causing bleeding. Methods we performed a prospective randomised controlled study during july 2006 to december 2007 in which 200 pregnant women in labour at 37 or more weeks of gestation were stratified.
The rationale is that augmenting amniotic fluid volume may decrease or eliminate problems associated with a severe reduction or absence of amniotic fluid, such as severe variable decelerations during labor. Therapeutic amnioinfusion for oligohydramnios during. For what do you prepare her you selected hospitalization. This method simply and effectively relieves variable decelerations not alleviated by the conventional measures of maternal position change and oxygen administration. Avoid strenuous activities for 24 hours after the amniocentesis. The nurse sees a pattern on the fetal monitor that looks similar to early decelerations, but the deceleration begins near the acme of the contraction and continues well beyond the end of the contraction. Intrauterine pressure catheter iupc amnioinfusion number. Preterm premature rupture of membranes is the single most identifiable cause of preterm labour.
The nurse should document the time of the amniotomy and the findings. Management of severe oligohydramnios with antepartum. Continuously monitor maternal vital signs and fetal heart rate during the amnioinfusion procedure. Transcervical amnioinfusion american family physician. Preterm premature rupture of membranes pprom is a leading cause of perinatal morbidity and mortality. Amnioinfusion guideline and procedure for amnioinfusion. Amnioinfusion indications, procedure, complications, define. The mechanisms underlying variable decelerations, the technique for. Intrapartum amnioinfusion as a preventive measure for. Results nine studies in the amnioinfusion group, 12 studies in the amniopatch group and 7.
Supplementing the amniotic fluid may diminish variable and prolonged types of fetal heart decelerations and diluting thick, meconiumstained fluid may also diminish the severity or. Adjust to higher doses by using patches that deliver more drug or by applying more than one patch. Nov 22, 2006 amnioinfusion is used to increase the volume of amniotic fluid around the fetus during pregnancy. Under ultrasonic guidance, a needle is inserted into the uterine cavity and saline or ringers lactate is infused until the level of amniotic fluid is normal. This technique provides both therapeutic and prophylactic regimens for the intrapartum mother and her fetus, and it has many clinical implications for nursing. Amnioinfusion for potential or suspected umbilical cord. At onset of attack, spray one to two metered doses into oral mucosa. The nurse should assess the amount, color, consistency, and odor of the amniotic fluid. Amnioinfusion is being used to treat intrapartum problems known to be associated with fetal compromise, including prophylactic treatment of. A total of 100 women at term in labor with meconium were randomized to infuse transcervical intrapartum amnioinfusion with saline 50 and routine obstetrical care 50. Policy and procedure this is a controlled document for internal use only. Laryngoscopic finding of meconium below the vocal cords in neonates was 36 % in the control group compared to only 6.
Prophylactic treatment of oligohydramnios, or reduction of variable decelerations of the fetal heart rate because of cord compression during labor, or treatment of preterm premature rupture of membranes at 26 weeks gestation or later. In this procedure, sterile saline is delivered into the amniotic cavity through a plastic tube. The official publication for icd9cm and icd10cmpcs coding guidelines and advice. A written protocol should specify how each method should be implemented and how al is to be individualized for each particular problem. When an amniotomy is performed, the nurse should record a baseline assessment of the fhr prior to the procedure and continuously during and after the procedure. If these measures are unsuccessful, cesarean section may become necessary. Write down your questions so you remember to ask them during your visits. Amnioinfusion aims to restore amniotic fluid volume by infusing a solution into the uterine cavity.
Amnioinfusion for third trimester preterm premature rupture. This chapter describes the nursing management required during pregnancy. The placenta has implanted in the correct location. Equipment includes a double lumen intrauterine pressure catheter, ns at room temperature, a fetal monitor and iv tubing. The mechanisms underlying variable decelerations, the technique for amnioinfusion administration, and two case studies are reported. Respiratory distress of the neonate was significantly less common in the study group than in the control group 4. Severe variable decelerations are due to cord compression correct explanation. Amnioinfusion aims to restore amniotic fluid volume by infusing a. Ipg192 amnioinfusion for oligohydramnios during pregnancy. The procedure may be repeated if oligohydramnios recurs serial amnioinfusion. Nursing responsibilities monitor fetal heart tones and contraction patterns continuously. Nursing responsibilities regarding amnioinfusion include pattern recognition, assisting with or initiation of amnioinfusion, and maintenance and evaluation of. However, a multicenter randomized controlled clinical trial found no benefit to amnioinfusion for this indication. At 31 weeks gestation, the goal would be to maintain the pregnancy as long as possible if the mother and fetus are tolerating continuation of the pregnancy.