Intrapartum amnioinfusion in meconium stained amniotic fluid at term pregnancy

Authors

  • Bharti Choudhary Parihar Department of Obstetrics and Gynaecology, GMC Bhopal, Madhya Pradesh
  • Babli Yadav Department of Obstetrics and Gynaecology, GMC Bhopal, Madhya Pradesh
  • Priyanka Sharde Department of Obstetrics and Gynaecology, GMC Bhopal, Madhya Pradesh
  • Jaya Patel Department of Obstetrics and Gynaecology, GMC Bhopal, Madhya Pradesh http://orcid.org/0000-0002-8021-8944

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20205456

Keywords:

Meconium, Amniotic fluid, MAS, Amnioinfusion

Abstract

Background: In our country a major cause of perinatal mortality and morbidity is meconium aspiration syndrome (MAS) in new-born. The aim of this study is to assess feto-maternal outcome following intrapartum amnioinfusion in patients with meconium stained amniotic fluid and the rate of ceaserean deliveries following intrapartum amnioinfusion in patients with meconium stained amniotic fluid.

Methods: This prospective observational study was conducted on 252 patients with pregnancy at or beyond 37 weeks in active labour with moderate to thick meconium stained amniotic fluid following spontaneous rupture or ARM. In such cases amnioinfusion was performed. Continuous electronic FHR monitoring was performed. Emergency 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 most, women had normal vaginal delivery 157 (62.30%) followed by LSCS 93 (36.91%) followed by forceps/vaccum delivery 02 (0.07%). No maternal complication was seen in 230 women (91.26%). Accidenatal hemorrhage was seen in 01 (0.39%) which was managed by emergency LSCS. Out of 252 neonates, 183 asymptomatic neonates at birth, 69 needed resuscitation and in which 52 neonates recovered and shifted back to mother and 17 neonates referred and admitted in NICU for MAS in which 07 were recovered and 10 neonates (3.96%) died due to MAS.

Conclusions: Intrapartum amnio infusion 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 the rate of caesarean section, these all leads to decrease the incidence of maternal and perinatal morbidity and mortality.

References

Wiswell TE, Bent RC. Meconium staining and meconium aspiration syndrome. Paediatr Clin North Am. 1993;40:995-81.

Katz VL, Bowes WA Jr. Meconium aspiration syndrome: reflections on a murky subject. Am J Obstet Gynecol. 1992;166:171-83.

Hofmeyr GJ. Amnioinfusion for meconium-stained liquor in labour. Cochr Database Syst Rev. 2002;(1).

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

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.

Osava RH, Silva FM, Oliveira SM, Tuesta EF, Amaral MC. Meconium-stained amniotic fluid and maternal and neonatal factors associated. Revista de saude publica. 2013;46:1023-9.

Samiyappa D, Ghose S, John L, Samal R. Maternal and perinatal outcome in meconium stained amniotic fluid at term. A case control study. Int J Reprod Contracept Obstet Gynecol. 2016:3404-10.

Mukhopadhyay P, Naskar T, Dalui R, Hazra S, Guin K, Bhattacharya D. Role of intrapartum amnioinfusion in meconium stained amniotic fluid. J Obstet Gynaecol India. 2006;56:230-2.

Asnani M, Singh S, Srivastava K, Gupta HP, Mittal A. Role of amnioinfusion in meconium stained liquor in relation to fetal outcome. Int J Reproduct, Contracept, Obstet Gynecol. 5(1):176.

Sood M, Aggarwal N, Faridi MM. Amnioinfusion in thick meconium. Ind J Pediat. 2004;71(8):677-81.

Pierce J, Gaudier FL, Sanchez- Ramos L. Intrapartum amnioinfusion for meconium stained fluid: meta-analysis of prospective clinical trials. Obstet Gynecol. 2000;95:1051-6.

Hofmeyr GJ. Amnioinfusion for meconium-stained liquor in labour. Cochr Database Syst Rev. 2014.

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

Sahu IM. Intrapartum amnioinfusion in meconium stained amniotic fluid. J Obst Gyne Ind. 2003;53:345-7.

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

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

Downloads

Published

2020-12-26

Issue

Section

Original Research Articles