Effect of Amnioinfusion on Outcome of Neonates Born With Meconium Stained Amniotic Fluid

Effect of Amnioinfusion on Outcome of Neonates Born With Meconium Stained Amniotic Fluid

Authors

  • Dr Pareshkumar A Thakkar
  • Dr Sheila Aiyer

Keywords:

Amnioinfusion, Meconium stained amniotic fluid

Abstract

Background & Objective: Meconium stained amniotic fluid (MSAF) is associated with significant morbidity and mortality. Amnioinfusion can decrease complications of MSAF. The objective was to study role of Amnioinfusion on outcome of babies born with MSAF. Methods: Design: Prospective Interventional Study
Setting: Medical college and SSG Hospital, Baroda, Gujarat. Study Period: from 1st March 2003 to 31st December 2003 Inclusion criteria: evidence of Thick MSAF AND station of the head is zero or above. Patients were grouped randomly in to two groups. In Group A amnioinfusion was performed while in Group B amnioinfusion was not done. Amnioinfusion was done by inserting foley catheter transcervically and infusing normal saline or ringer lactate at the rate of 100ml/min till the coming liquor became clear. Outcome was studied. Results: Out of total 227 babies with thick MSAF amnioinfusion was performed in 52 patients (Group A), rest 175 patients were controls (Group B). Incidence of MAS was significantly lower 7.7% in Group A compared to 25.7% of Group B (P < 0.005). There was significantly lower incidence of birth asphyxia 1.92% in Group A compared to 34.8% in Group B (P value < 0.0001). Incidence of HIE was significantly lower in group A. Incidence of Air leaks and PPHN was similar in both groups. Rate of NICU admission was significantly lower in group A (13.4%) compared to group (51.4%), P value < 0.001. Mortality in Group A was much lower 5.8% compared to 14.85% in Group B (p =0.08). Amnioinfusion did not increase risk of maternal or neonatal sepsis.
Conclusion: Amnioinfusion significantly decreases complications of MSAF and improves perinatal survival

References

1. Cleary GM, Wiswell TE. Meconium stained
amniotic fluid and meconium aspiration
syndrome- An update. Pediatr Clin North Am
1998; 45, 511-525.
2. Hofmeyr GJ. Amnioinfusion for meconium
stained liquor in labour (Cochrane Review). In
cochrane Library, Issue 2, 2004. Oxford :
update.
3. Pierce J, Gaudier FL, Sanchez-Ramos L.
Intrapartum amnioinfusion for meconium
stained amniotic fluid : meta-analysis of
prospective clinical trials. Obstet Gynecol. 2000;
95: 1051-1056.
4. Hofmeyr GJ, Gulmezoglu AM, Buchmann E,
Howarth GR, Shaw A, Nikodem VC, Cronje H, de
Jager M, Mahomed K. The Collaborative
Randomized Amnioinfusion for Meconium
Project (CRAMP) : 1 south Africa. Br J Obstet
Gynecol. 1998; 105: 304-308.
5. Adam K, Cano L, Moise KJ. The effect of
intrapartum amnioinfusion on the outcome of
the fetus with heavy meconium stained
amniotic fluid. Proceedings of 9th Annual
Meeting of the Society of Perinatal
Obstetricians; 1989 Feb 1-4: New Orleans,
Louisiana, USA. 1989: 438
6. Wenstrom KD, Andrews WW, Maher JE.
Prevalence, protocols and complications
associated with amnioinfusion. American
Journal of Obstetrics and Gynecology 1994;170:
341.
7. Contributors and Reviewers for the Neonatal
Resuscitation Guidelines. International
Guidelines for Neonatal Resuscitation : An
excerpt from the guidelines 2000 for
cardiopulmonary resuscitation and emergency
cardiovascular care : International consensus
conscience. Pediatrics 2000; 106:e29.
8. Lo KWK, Rogers M. A controlled trial of
Amnioinfusion : the prevention of meconium
aspiration in labour, Aust N Z J Obstet Gynecol.
1993; 33: 51-54.
9. Uhing MR, Bhat R, Philobos M, Raju TNK. Value
of Amnioinfusion in reducing MAS, Am J
Perinatol. 1993; 10: 43-45.
10. Eriksen N, Hostetter M, Parisi V. Prophylactic
Amnioinfusion in pregnancies complicated by
thick meconium. Am J Obstet Gynecol. 1994;
171: 1026-1030.
11. Cialone PR, Sherer DM, Ryan RM, Sinkin RA,
Abramowicz JS. Amnioinfusion during labour
complicated by particulate meconium stained
amniotic fluid decreases neonatal morbidity.
Am J Obstet Gynecol. 1994; 170: 842-849.
12. De Meeus JB, d'Halluin G, Bascou V, et al.
Prophylactic intrapartum amnioinfusion : a
controlled retrospective study of 135 cases. Eur
J Obstet Gynecol Reprod Biol. 1997; 72: 141-
148.
13. Puertas A, Carillo MP, Molto L, Alvarez M,
Sedeno S, Miranda JA. MSAF in labour : a
randomized trial of prophylactic amnioinfusion.
Eur J Obstet Gynecol Reprod Biol. 2001; 99: 33-
37.
14. Sahu L, Indervani M. Intrapartum Amnioinfusion
for meconium stained amniotic fluid. J Obstet
Gynecol Ind. 2003; 53: 345-347.
15. Spong CY, Ogundipe OA, Ross MG. Prophylactic
Amnioinfusion for MSAF. Am J Obstet Gynecol.
1994; 171: 931-935.
16. Usta I.M., Mercer B.M., Aswad N.K., Sibai B.M.
The impact of a policy of amnioinfusion for
MSAF. Obstet Gynecol 1995; 85: 237-241.
17. Moodley J, Matchaba P, Payne AJ. Intrapartum
amnioinfusion for meconium stained Liquor in
developing countries. Trop Doct. 1998; 28: 31-
34.
18. Rathore AM, Singh R, Ramji S, Tripathi R.
Randomized trial of Amnioinfusion during
labour with MSAF. Br J Obstet Gynecol: 2002;
109: 17-20.

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Published

2012-06-30

How to Cite

Thakkar, D. P. A., & Aiyer, D. S. (2012). Effect of Amnioinfusion on Outcome of Neonates Born With Meconium Stained Amniotic Fluid: Effect of Amnioinfusion on Outcome of Neonates Born With Meconium Stained Amniotic Fluid. National Journal of Integrated Research in Medicine, 3(2), 76–80. Retrieved from http://nicpd.ac.in/ojs-/index.php/njirm/article/view/2000

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