[Significance of amnioinfusion and amniotic fluid exchange under continuous internal fetal heart rate monitoring for management of fetal distress during labor].
OBJECTIVE
To discuss the significance of amnioinfusion and amniotic fluid exchange under continuous internal fetal heart rate (FHR) monitoring for management of fetal distress during labor.


METHODS
136 cases with frequent variable deceleration (VD) and meconium stained amniotic fluid during labor were divided into two groups: the study group (68 cases) and the control group (68 cases). The former were treated by amnioinfusion and amniotic fluid exchange, while oxygen inhalation, change of body position, and intravenous infusion for the control group.


RESULTS
In the study group, VD disappeared or relieved in 62 cases obviously, and the efficacy rate reached 91.2% (62/68). 48 cases with II degree meconium stained amniotic fluid were treated by amniotic fluid exchange, amniotic fluid became clear or turned to I degree stained in 39 cases. In the control group, VD relieved in 20 cases, the efficacy rate was 19.4%, significantly lower than that of the study group (P < 0.01). In the study group, cesarean section rate was 14.7% neonatal asphyxia 7.4% while they were 47.1% and 48.5% in the control group respectively (P < 0.01; P < 0.01). Neonatal pneumonia caused by meconium aspiration occurred in 13 cases, meconium aspiration syndrome (MAS) 8 cases, with 5 newborns died in the control group, while there was no neonatal death in the study group. There was no significant difference on puerperal morbidity between the 2 groups (P > 0.05).


CONCLUSIONS
Amnioinfusion and AF exchange during labor are one of the effective treatment methods for fetal distress and prevention for MAS.
Zhao
S
S
Department of Obstetrics, Maternal and Children Health Hospital of Shanxi province, Xi'an 710003, China.
Ai
L
L
Zhang
H
H
D000328:Adult; D000650:Amnion; D000653:Amniotic Fluid; D005260:Female; D005316:Fetal Distress / Q000175:diagnosis / Q000628:therapy*; D005440:Fluid Therapy / Q000379:methods*; D006340:Heart Rate, Fetal; D006801:Humans; D007231:Infant, Newborn; D007743:Labor, Obstetric; D008470:Meconium; D008471:Meconium Aspiration Syndrome / Q000517:prevention & control; D011247:Pregnancy; D012965:Sodium Chloride / Q000008:administration & dosage
D012965:Sodium Chloride