Therapeutic amnioinfusion for oligohydramnios during pregnancy (excluding labour)

Summary

The National Institute for Health and Clinical Excellence (NICE) issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on therapeutic amnioinfusion for oligohydramnios during pregnancy in November 2006. In accordance with the Interventional Procedures Programme Process Guide, guidance on procedures with special arrangements are reviewed 3 years after publication and the procedure is reassessed if important new evidence is available.

The guidance was considered for reassessment in November 2009 and it was concluded that NICE will not be updating this guidance at this stage. However, if you believe there is new evidence which should warrant a review of our guidance, please contact us via the email address below.

Description

During pregnancy, the level of amniotic fluid increases rapidly to reach a peak at about 36 weeks gestation after which time it may start to gradually decrease. Oligohydramnios is the presence of an abnormally low volume of amniotic fluid (AF) surrounding the fetus. It may be due to an excess loss of fluid or a decrease in fetal urine production or excretion. The condition can occur at any stage of pregnancy but it is most common in the last trimester.

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 Ringer's lactate is infused until the level of amniotic fluid is normal. The procedure may be repeated if oligohydramnios recurs (serial amnioinfusion).

NICE Pathways

This guidance has been incorporated into the following NICE Pathways, along with other related guidance and products.

Visit the NICE Pathway: antenatal care

OPCS4.6 Code(s):

R10.8 Other specified other operations on amniotic cavity

Y38.1 Continuous injection of therapeutic substance into organ NOC

A code from Y95.- Gestational age must be assigned in a subsidiary position where this information is available.

In addition the ICD-10 code O41.0 Oligohydramnios is assigned.

_{The NHS Classifications Service of NHS Connecting for Health is the central definitive source for clinical coding guidance and determines the coding standards associated with the classifications (OPCS-4 and ICD-10) to be used across the NHS.   The NHS Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided.  www.connectingforhealth.co.uk/clinicalcoding}

Details

Contact details:

Links:

	IPG192 Amnioinfusion for oligohydramnios during pregnancy - guidance	22 November 2006
	IPG192 Amnioinfusion for oligohydramnios during pregnancy - guidance (web format)	04 February 2011
	IPG192 Amnioinfusion for oligohydramnios during pregnancy - information for the public	22 November 2006
	IPG192 Amnioinfusion for oligohydramnios during pregnancy - information for the public (word version)	22 November 2006
	IPG192 Amnioinfusion for oligohydramnios during pregnancy: Audit criteria	18 December 2006
	Therapeutic amnioinfusion for oligohydramnios during pregnancy (excluding labour) (interventional procedures consultation)	27 June 2006
	Therapeutic amnioinfusion for oligohydramnios during pregnancy (excluding labour) (interventional procedures overview)	27 June 2006