Current evidence on the safety and efficacy of therapeutic amnioinfusion for oligohydramnios during pregnancy (excluding labour) does not appear adequate for this procedure to be used without special arrangements for consent and for audit or research. Most of the evidence on the procedure relates to preterm premature rupture of membranes, rather than other causes of oligohydramnios.
Clinicians wishing to undertake therapeutic amnioinfusion for oligohydramnios during pregnancy (excluding labour) should take the following actions.
Inform the clinical governance leads in their Trusts.
Ensure that parents understand the uncertainty about the procedure's safety and efficacy, including the potential risks to the mother, and provide them with clear written information. In addition, use of NICE's information for the public is recommended.
Audit and review clinical outcomes of all patients having therapeutic amnioinfusion for oligohydramnios during pregnancy (see NICE's interventional procedures outcomes audit tool).
Therapeutic amnioinfusion for oligohydramnios during pregnancy should only be performed in centres specialising in invasive fetal medicine and in the context of a multidisciplinary team, which may include a consultant in fetal medicine, a neonatologist and a specialist midwife.
Further research will be useful. Clinicians are encouraged to enter patients into well-designed randomised controlled trials comparing therapeutic amnioinfusion with no intervention. NICE may review the procedure upon publication of further evidence.