There is some evidence to show that restoring amniotic fluid volume with saline or a similar fluid (amnioinfusion) following preterm premature rupture of the membranes (PPROM) may be beneficial for preterm babies (by preventing infection, lung damage and death) and mothers (by preventing infection of the womb after childbirth). However, current evidence is insufficient to recommend amnioinfusion for routine use in PPROM.
Preterm premature rupture of membranes is the single most identifiable cause of preterm labour. The sac (membranes) surrounding the baby and fluid in the womb (uterus) usually breaks (ruptures) during labour. If the membranes rupture before labour and preterm (before 37 weeks) the baby has an increased risk of infection. Reduced fluid around the baby also increases the chance of the umbilical cord being compressed, which can reduce the baby's supply of nutrients and oxygen. In addition, insufficient fluid in the womb may interfere with normal lung development in very small babies and can cause fetal distress, with changes in heart rate. Extra liquid can be injected through the woman's vagina (transcervical amnioinfusion) or abdomen (transabdominal amnioinfusion) into the womb, providing more liquid to surround the baby. The review of five randomised controlled trials (with data from a total of 241 participants analysed) found some evidence to show that amnioinfusion with a saline solution may improve health outcomes and be beneficial for babies and mothers following PPROM. However, the evidence is currently insufficient to recommend its routine use because of the limited number of trials and low numbers of women in the trials.