Role of amnioinfusion in meconium stained liquor in relation to fetal outcome


  • Mona Asnani Department of Obstetrics & Gynaecology, ERA'S Lucknow Medical College, Lucknow, India
  • Shivani Singh Department of Obstetrics & Gynaecology, ERA'S Lucknow Medical College, Lucknow, India
  • Kumkum Srivastava Department of Obstetrics & Gynaecology, ERA'S Lucknow Medical College, Lucknow, India
  • Hem Prabha Gupta Department of Obstetrics & Gynaecology, ERA'S Lucknow Medical College, Lucknow, India
  • Anushree Mittal Department of Obstetrics & Gynaecology, ERA'S Lucknow Medical College, Lucknow, India



Amnioinfusion, Meconium aspiration syndrome, Fetal outcome


Background: Meconium aspiration syndrome complicates 1.7 to 35.8% of deliveries. The meconium aspiration syndrome is believed to result from aspiration of meconium during intrauterine gasping or at the time of first breath. Transcervical infusion of saline into amniotic cavity or amnioinfusion has been proposed as a method to reduce the risk of the meconium aspiration syndrome.

Methods: The study was conducted in Department of Obstetrics and gynecology in collaboration with the department of paediatrics, Era’s Lucknow Medical College, Lucknow, India in the study period of 18 months. It was a prospective case control study. A total number of 80 patients were enrolled for the purpose of study. The patients were randomly divided into two groups. Control group (n=40) those who received standard treatment (i.e. labor analgesia, maternal nutrition and record of progress of labor) and Study group (n=40) patients who were managed by giving amnioinfusion in addition to the standard treatment. Both groups were compared in terms of fetal outcome. Data so obtained was subjected to statistical analysis using statistical package for Social Science Version 15.0.

Results: Majority of babies of control group (n=22, 55%) have Apgar score at 1 minute was <7 whereas majority of babies born to mothers of study group (n=27, 67.5%) have apgar scores at 1 minute was ≥7.    Resuscitative measures were required in majority of control group babies (n=22, 55%) as compared to only 13 (32.5%) babies of study group. Meconium aspiraton syndrome was present in 12 babies (30%) of control group as compared to only 4 babies (10%) of study group. Rate of neonatal death was higher in control group (5%) as compared to study group (2.5%). A total of 25 (62.5%) babies required NICU admission in control group and 15 (37.5) babies in study group.

Conclusions: The findings in present study indicates that aminoinfusion in a well-equipped tertiary care unit reduces the rate of caesarean section significantly while at the same time influences the neonatal outcome in terms of better Apgar score, reduced need of resuscitative measures and reduced neonatal morbidity.


Brown BL, Gleicher N. Intrauterine meconium aspiration. Obtst Gynecol. 1981;57:26-9.

Davis RO, Philips JB III, Haris BA Jr, Wilson ER, Huddleston JF. Fetal meconium aspiration syndrome occurring despite airway management considered appropriate. Am J ObstetGynecol. 1985;151:731-6.

Urbaniak KJ, McCowan LME, Townend KM. Risk factors for meconium aspiration syndrome. Aust N Z J ObstetGynecol. 1996;36:401-6.

Hofmeyr GJ. Amnioinfusion for meconium-stained liquor in labor. Cochrane Database Syst Rev. 2002;(1):CD000014.

Miyazaki FS, Taylor NA. Saline amnioinfusion for relief of variable or prolonged declerations: A preliminary report. Am J Obstet Gynecol. 1983;146:670-8.

Ashfaq F, Shah AA. Effect of Amnioinfusion for meconium Stained Amniotic Fluid on Perinatal Outcome. J Pak Med Assoc. 2004;54(6):322-5.

Caltart TM, Byrne DL, Bates SA. Meconium aspiration syndrome: a 6 year retrospective study. Br J Obs Gynae. 1989;96:411-4.

Meis BJ, Hall M, Marshall JR, Hobel CJ. Meconium passage: a new classification for risk assessment in labour. Am J Obstet Gynaecol. 1978;151:509-12.

Mitchell J, Schulman H, Fleisher A , Farmakides G, Nadeau D. Meconium aspiration and fetal acidosis. Obstet Gynaecol. 1985;65:352-5.

Wood JR Jr, Dolkart LA. Significance of amniotic fluid meconium. In: Creasy RK, Resnik R, eds. Maternal fetal medicine: principles and practice. Philadelphia: WB Saunders. 1989:404.

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.

Sood M, Charulata, Dimple, Aggarwal N, Faridi MM. Amnioinfusion in thick meconium. Indian J Pediatr. 2004;71(8):677-81.

Singh A, Magu D. Fetomaternal outcome in transcervical amnioinfusion in meconium stained fluid. J ObstetGynecol India. 2005;55(1):57-60.

Kamal PP, Swamy MK, Samatha K. A one year cross sectional study of management practices of meconium stained amniotic fluid and perinatal outcome. J ObstetGynecol India. 2006;56(2):128-30.

Das AK, Jana N, Dasgupta S, Samanta B. Intrapartum transcervical amnioinfusion for meconium-stained amniotic fluid. Int J Gyn Obs. 2007;97(3):182-6.

Ajmal W, Zaki A, Aliya, Bashir U, Naveeda, PAshtana et al. Is amnioinfusion effective enough to reduce perinatal mortality? JPMI. 2007;21(4):256-9.

Engel K, Samborska M, Bilar M, Sipak-Szmigiel O, Ronin-Walknowska E. Intrapartumamnioinfusion in patients with meconium-stained amniotic fluid. Ginekol Pol. 2008;79(9):621-4.

Sharma M. Intrapartum amnioinfusion for meconium stained amniotic fluid and fetal outcome. Dissertation for M.S. (Obs. & Gyn.) RGUHS, 2009.

Rogers MS, Lau TK, Wang CC, Yu KM. Amnioinfusion for the prevention of meconium asriration during labour. Aust N Z J ObstetGynaecol. 1996;36(4):407-10.

Wenstrom KD, Parsons MT. The prevention of meconium aspiration in labour using amnioinfusion. Obstet Gynecol. 1989;73:647-51.

Lambet A, Zorlu CG, Yalcin HR, Seckin B, Batioglu S, Gokmen O. Prophylactic transabdominal amnioinfusion during labor with thick meconium: does it work? Eur J Obstet Gynecol Reprod Biol. 1999;86:S80.

Uhing MR, Bhat R, Philobes M, Raju TN. Value of amnioinfusion in reducing meconium aspiration syndrome. Am J Perinatol. 1993;10(1):43-5.

Mahomed K, Mulambo T, Woelk G, Hofmeyr GJ, Gülmezoğlu AM. The Collaborative Randomised Amnioinfusion for Meconium Project (CRAMP): 2. Zimbabwe. Br J Obstet Gynaecol. 1998;105(3);309-13.

Choudhary D, Bano I, Ali SM. Does amnioinfusion reduce caesarean section rate in meconium-stained amniotic fluid. Arch Gynecol Obstet. 2010;282(1):17-22.






Original Research Articles