Objective: During amnioinfusion exchange (AE) a certain amount of amniotic fl uid is repeatedly extracted and the same amount of physiological solution is consequently instilled into the amniotic fetal cavity. The aim of this procedure is to dilute the amniotic fl uid that surrounds the eviscerated organs of fetuses with laparoschisis so as to avoid the genesis of fi brous coating on these organs. Design: Prospective study. Setting: Gynekologicko-pôrodnícka klinika SZU, FNsP akad. L. Dérera, Bratislava, Slovakia. Methods: We have executed AE in fi ve fetuses with laparoschisis since June 2002. Two patients underwent the treatment 2 times during the 32nd and 36th weeks of gestation. Two other patients were treated once during the 32nd week and one patient once during the 36th week. Under ultrasound control we used a spinal needle to extract 120-180 ml of dense, cloudy amniotic fl uid. Consequently, we instilled the same amount of physiological solution warmed up to the temperature of 37 °C into the amniotic cavity through antibacterial fi lter. The fetuses were monitored cardiotocographically and with the help of ultrasound fl owmetry in umbilical vessels, before and after the treatment. Results: The AE were successful and without complications in all fi ve cases. All patients delivered via elective caesarean section during the 36th – 37th gestation week. One patient delivered 24 hours after second AE due to the danger of intrauterine fetal hypoxia that was verifi ed cardiotocographically. The other patients delivered 1-4 weeks after AE. Conclusion: The signifi cance of AE lies primarily in the reduction of the occurence of fi brous coating on eviscerated organs. It enables postnatal primary surgical closure of the defect in the front abdominal wall, an earlier onset of intestine peristalsis, transition from parenteral to peroral nutrition and shorter hospitalization.

        Key words: laparoschisis, amnioinfusion exchange, caesarean section