Miyazaki F S, Nevarez F
Am J Obstet Gynecol. 1985 Oct 1;153(3):301-6. doi: 10.1016/s0002-9378(85)80116-2.
A prospective randomized study was undertaken in order to further investigate the effect of intrauterine saline amnioinfusion for the relief of repetitive variable decelerations in the first stage of labor. Intrauterine saline amnioinfusion corrects the oligohydramnios that makes the cord more vulnerable to compression during uterine contractions. Included in this study were 96 patients who had repetitive variable decelerations not relieved either by changes in position or by oxygen. Randomization resulted in 49 patients in the infusion group and 47 patients in the noninfusion group. Relief of variable decelerations was 51% in the infusion group, as compared to 4.2% in the noninfusion group. Relief of variable decelerations was more dramatic in the nulliparous infusion group (66.7%) than in the noninfusion group (0%). In the nulliparous patients there was a significant decrease in the rate of cesarean sections for fetal distress, being 14.8% in the infusion group as compared to 47.6% in the noninfusion group. This study clearly showed that saline amnioinfusion is a logical, simple, safe, and effective therapy for the relief of repetitive variable decelerations in the first stage of labor and can lower the incidence of cesarean sections for fetal distress in nulliparous patients. Furthermore, amnioinfusion was much superior to changes in position in treating repetitive variable decelerations.
为了进一步研究羊膜腔内注入生理盐水对缓解第一产程中反复出现的变异减速的效果，进行了一项前瞻性随机研究。羊膜腔内注入生理盐水可纠正羊水过少的情况，而羊水过少会使脐带在子宫收缩时更容易受到压迫。本研究纳入了96例经改变体位或吸氧均无法缓解反复出现变异减速的患者。随机分组后，输液组有49例患者，非输液组有47例患者。输液组变异减速缓解率为51%，而非输液组为4.2%。初产妇输液组变异减速缓解率（66.7%）比非输液组（0%）更显著。在初产妇中，因胎儿窘迫而行剖宫产的比率显著降低，输液组为14.8%，而非输液组为47.6%。这项研究清楚地表明，羊膜腔内注入生理盐水是缓解第一产程中反复出现的变异减速的一种合理、简单、安全且有效的治疗方法，并且可以降低初产妇因胎儿窘迫而行剖宫产的发生率。此外，在治疗反复出现的变异减速方面，羊膜腔灌注远优于改变体位。
