title: Amnioinfusion for the prevention of the meconium aspiration syndrome.
abstract: BACKGROUND
  It is uncertain whether amnioinfusion (infusion of saline into the amniotic cavity) in women who have thick meconium staining of the amniotic fluid reduces the risk of perinatal death, moderate or severe meconium aspiration syndrome, or both.
  
  
  METHODS
  We performed a multicenter trial in which 1998 pregnant women in labor at 36 or more weeks of gestation who had thick meconium staining of the amniotic fluid were stratified according to the presence or absence of variable decelerations in fetal heart rate and then randomly assigned to amnioinfusion or to standard care. The composite primary outcome measure was perinatal death, moderate or severe meconium aspiration syndrome, or both.
  
  
  RESULTS
  Perinatal death, moderate or severe meconium aspiration syndrome, or both occurred in 44 infants (4.5 percent) of women in the amnioinfusion group and 35 infants (3.5 percent) of women in the control group (relative risk, 1.26; 95 percent confidence interval, 0.82 to 1.95). Five perinatal deaths occurred in the amnioinfusion group and five in the control group. The rate of cesarean delivery was 31.8 percent in the amnioinfusion group and 29.0 percent in the control group (relative risk, 1.10; 95 percent confidence interval, 0.96 to 1.25).
  
  
  CONCLUSIONS
  For women in labor who have thick meconium staining of the amniotic fluid, amnioinfusion did not reduce the risk of moderate or severe meconium aspiration syndrome, perinatal death, or other major maternal or neonatal disorders.
authors.affiliation: Department of Obstetrics and Gynecology, Hôpital Sainte-Justine, Université de Montréal, Montreal, QC, Canada. william.fraser@umontreal.ca
authors.forename: William D
authors.initials: WD
authors.lastname: Fraser
authors.forename: Justus
authors.initials: J
authors.lastname: Hofmeyr
authors.forename: Roberto
authors.initials: R
authors.lastname: Lede
authors.forename: Gilles
authors.initials: G
authors.lastname: Faron
authors.forename: Sophie
authors.initials: S
authors.lastname: Alexander
authors.forename: François
authors.initials: F
authors.lastname: Goffinet
authors.forename: Arne
authors.initials: A
authors.lastname: Ohlsson
authors.forename: Céline
authors.initials: C
authors.lastname: Goulet
authors.forename: Lucile
authors.initials: L
authors.lastname: Turcot-Lemay
authors.forename: Walter
authors.initials: W
authors.lastname: Prendiville
authors.forename: Sylvie
authors.initials: S
authors.lastname: Marcoux
authors.forename: Louise
authors.initials: L
authors.lastname: Laperrière
authors.forename: Chantal
authors.initials: C
authors.lastname: Roy
authors.forename: Stavros
authors.initials: S
authors.lastname: Petrou
authors.forename: Hai-Rong
authors.initials: HR
authors.lastname: Xu
authors.forename: Bin
authors.initials: B
authors.lastname: Wei
mesh_terms: D000653:Amniotic Fluid; D005260:Female; D005316:Fetal Distress; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000517:prevention & control; D007263:Infusions, Parenteral; D008471:Meconium Aspiration Syndrome / Q000517:prevention & control*; D007744:Obstetric Labor Complications / Q000628:therapy*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012965:Sodium Chloride / Q000627:therapeutic use*; D017211:Treatment Failure
chemical_list: D012965:Sodium Chloride