Amnioinfusion in thick meconium.
OBJECTIVE
There are conflicting reports regarding the results of amnioinfusion in the management of meconium passage in utero. This study was done to evaluate transcervical amnioinfusion for meconium stained amniotic fluid during labour.


METHODS
196 women at term in early labour with meconium were randomized to receive either transcervical intrapartum amnioinfusion with saline (96) or routine obstetrical care (100). Transcervical amnioinfusion of one liter saline infused over 30-45 minutes. End points were relief of decelerations, incidence of vaginal delivery, presence of meconium below the neonatal cords, and X-ray evidence of meconium aspiration.


RESULTS
Amnioinfusion resulted in relief of decelerations in 75% of cases as compared to 7% in the control group. Eighty-eight percent of patients delivered vaginally as compared to 58% in the control group (p< 0.001). Neonatal outcome was significantly better in the infusion group. The incidence of meconium below the vocal cords was reduced from 48% to 17% (p< 0.004) using amnioinfusion with positive X-rays for meconium aspiration in only 12.5% versus 26% (p < 0.5).


CONCLUSIONS
We concluded that transcervical intrapartum amnioinfusion is a safe, simple and inexpensive technique that reduces operative intervention and improves neonatal outcome, and is of tremendous relevance in developing countries.
Sood
Mini
M
Department of Obstetrics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India. drminisood@hotmail.com
Charulata
Dimple
Aggarwal
Neera
N
Faridi
M M A
MM
D000653:Amniotic Fluid; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007263:Infusions, Parenteral; D007743:Labor, Obstetric; D008470:Meconium; D008471:Meconium Aspiration Syndrome / Q000517:prevention & control; D011247:Pregnancy; D011256:Pregnancy Outcome; D012965:Sodium Chloride / Q000008:administration & dosage
D012965:Sodium Chloride