Purpose: To outline nursing responsibilities in setting up and assisting with amnioinfusion. 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.Policy: Amnioinfusion is initiated by a physician and monitored by trained, licensed New Life Center associates as deemed appropriate by physician.
Assisting Physician with Amnioinfusion1. Explain the procedure to the patient.2. Assist in dorsal recumbent position. Assist with draping and exposing vaginal area.3. Connect IUPC tubing to IV fluid, flush.4. Connect the catheter to the monitor cable and zero monitor. Maintain zero slide valve in closed position.5. Assist physician with insertion of double lumen IUPC and connect IV tubing to the amnioport to begin amnioinfusion.6. Infuse 500cc bolus over 20-30 minutes by gravity flow via IUPC infusion port.7. Infuse at 100-150 cc/hr as maintenance dose or as directed by physician.
Nursing Responsibilities• Monitor fetal heart tones and contraction patterns continuously.• Discontinue amnioinfusion if any of the following occur and notify physician: • Decelerations have not been relieved after 500 cc infused. Place patient in trendelenburg if leakage is excessive and/or decelerations have not terminated after 500 cc infusion. • Increasing uterine resting tone • Signs of fetal compromise • Bleeding • Uterine tenderness
Documentation• Uterine resting tone prior to initiation of infusion.• Placement of IUPC and patient response.• Infusion onset and volume infused.• Volume of infusion fluid required to relieve decelerations, if decelerations present.• Fluid returned (pad counts, volume)• Patient position.• Vaginal exam findings.