Effects of amnioinfusion in meconium-stained amniotic fluid complicating pregnancy
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20213475Keywords:
Amnioinfusion, Meconium-stained amniotic fluid, NICUAbstract
Background: In our country a major cause of perinatal mortality and morbidity is MAS (MAS) in new-born. The aim of the study was to assess feto-maternal outcome following intrapartum amnioinfusion in patients with meconium-stained amniotic fluid and Neonatal intensive care unit (NICU) admission following intrapartum amnioinfusion in patients with meconium stained amniotic fluid.
Methods: This prospective observational study was conducted on 200 patients with pregnancy at or beyond 37 weeks in active labour with moderate to thick meconium stained liqour following spontaneous rupture or Artificial rupture of membranes (ARM). In 100 patients amnioin fusion was performed and rest 100 were in control group. Continuous electronic fetal heart rate (FHR) monitoring was performed. Emergency lower segment caesarean section (LSCS) was done when fetal bradycardia was recorded or in case of non-progress of labor. Fetomaternal outcome will be noted.
Results: In present study there were more cases of fetal distress in the control group (38) compared with the amnioinfusion group (24). 34 patients in the amnioinfusion group and 38 patients in the control group were delivered by LSCS. The incidence of MAS in amnioinfusion group was 3 in number where as 14 in number of control group. Similarly, in our study 13 neonates of amnioinfusion group and 31 neonates of control group were needed admission in NICU.
Conclusions: Intrapartum amnioinfusion in meconium-stained amniotic fluid by diluting the meconium and by decreasing the cord compression decreases the incidence of foetal distress and there by decreases incidence of MAS in neonates and NICU admission, these all leads to decrease the incidence of maternal and perinatal morbidity and mortality.
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References
Oyelese Y, Culin A, Ananth CV, Kaminsky LM, Vintzileos A, Smulian JC. Meconium-stained amniotic fluid across gestation and neonatal acid-base status. Obstet Gynecol. 2006;108(2):345-9.
Addisu D, Asres A, Gedefaw G, Asmer S. Prevalence of meconium stained amniotic fluid and its associated factors among women who gave birth at term in Felege Hiwot comprehensive specialized referral hospital, North West Ethiopia: a facility based cross-sectional study. BMC Pregnancy Childbirth. 2018;18(1):429.
Usta IM, Mercer BM, Aswad NK, Sibai BM. The impact of a policy of amnioinfusion for meconium-stained amniotic fluid. Obstet Gynecol. 1995;85(2):237-41.
Cialone PR, Sherer DM, Ryan RM, Sinkin RA, Abramowicz JS. Amnioinfusion during labor complicated by particulate meconium-stained amniotic fluid decreases neonatal morbidity. Am J Obstet Gynecol. 1994;170(3):842-9.
Wenstrom KD, Parsons MT. The prevention of meconium aspiration in labor using amnioinfusion. Obstet Gynecol. 1989;73(4):647-51.
Lo KW, Rogers M. A controlled trial of amnioinfusion: the prevention of meconium aspiration in labour. Aust N Z J Obstet Gynaecol. 1993;33(1):51-4.
Rathor AM, Singh R, Ramji S, Tripathi R. Randomised trial of amnioinfusion during labour with meconium stained amniotic fluid. BJOG. 2002;109(1):17-20.
Moodley J, Matchaba P, Payne AJ. Intrapartum amnioinfusion for meconium-stained liquor in developing countries. Trop Doct. 1998;28(1):31-4.
Eriksen NL, Hostetter M, Parisi VM. Prophylactic amnioinfusion in pregnancies complicated by thick meconium. Am J Obstet Gynecol. 1994;171(4):1026-30.
Spong CY, Ogundipe OA, Ross MG. Prophylactic amnioinfusion for meconium-stained amniotic fluid. Am J Obstet Gynecol. 1994;171(4):931-5.
Mahomed K, Mulambo T, Woelk G, Hofmeyr GJ, Gulmezoglu AM. The Collaborative Randomised Amnioinfusion for Meconium Project (CRAMP): 2. Zimbabwe. Br J Obstet Gynaecol. 1998;105(3):309-13.
Macri CJ, Schrimmer DB, Leung A, Greenspoon JS, Paul RH. Prophylactic amnioinfusion improves outcome of pregnancy complicated by thick meconium and oligohydramnios. Am J Obstet Gynecol. 1992;167(1):117-21.
Keith WK, Rogers M. A controlled trial of amnioinfusion: the prevention of meconium aspiration in labour. Aust NZ Obstet Gynecol, 1993; 33(1):51-4.
Hofmeyr GJ, Xu H. Amnioinfusion for meconium-stained liquor in labour. Cochrane Database Syst Rev. 2010;(1):14.
Mukhopadhyay G, Burman SK, Sikder K, Chatterjee B. Intrapartum amnioinfusion in meconium stained amniotic fluid and fetal outcome. AICOG. 2003.