Study of role of intrapartum transcervical amnioinfusion in labour complicated by meconium stained amniotic fluid.

Background: The passage meconium in utero has been noted in 7-22 % of live births. It puts the neonate at risk of for meconium aspiration syndrome (MAS). The risk of meconium aspiration is high with thick meconium, therefore any mechanism by which thick meconium can be converted into thin meconium is postulated to have positive effect on neonatal outcome. Amnioinfusion theoretically restores amniotic fluid volume, dilutes thick meconium & cushions the umbilical cord which reduces cord compression. This study is an effort to evaluate whether amnioinfusion helps in reducing neonatal morbidity & mortality in patients with meconium stained amniotic fluid (MASF); also to see whether it decreases operative intervention in mother. Methods: In prospective randomised study, 160 pregnant women with meconium stained liquor were categorised into amnioinfusion group and control group with 80 patients in each. Amnioinfusion group received transcervical amnioinfusion in addition to routine care. Maternal complications and neonatal outcome in both groups were compared. Results: Amnioinfusion group had higher incidence of vaginal delivery especially in multipara and maternal complications and neonatal outcome was comparable in both the groups. Meconium aspiration syndrome was significantly less in case group neonates. Conclusion: AI significantly reduces the incidence of MAS, meconium below vocal cords and therefore reduces requirement for mechanical ventilation and NICU admission. Amnioinfusion is relatively easy to perform, inexpensive and safe technique that reduces operative intervention (caesarean section) and can play a major role in management of patients with meconium stained liquor especially in developing countries with limited resources. [ABSTRACT FROM AUTHOR]