Publication:

Intrapartum amnioinfusion in meconium stained amniotic fluid at term pregnancy

Background In our country a major cause of perinatal mortality and morbidity is meconium aspiration syndrome (MAS) in new-born. The aim of this study is to assess feto-maternal outcome following intrapartum amnioinfusion in patients with meconium stained amniotic fluid and the rate of ceaserean deliveries following intrapartum amnioinfusion in patients with meconium stained amniotic fluid.

Methods This prospective observational study was conducted on 252 patients with pregnancy at or beyond 37 weeks in active labour with moderate to thick meconium stained amniotic fluid following spontaneous rupture or ARM. In such cases amnioinfusion was performed. Continuous electronic FHR monitoring was performed. Emergency LSCS was done when fetal Bradycardia was recorded or in case of non-progress of labor. Fetomaternal outcome will be noted.

Results In present study most, women had normal vaginal delivery 157 (62.30%) followed by LSCS 93 (36.91%) followed by forceps/vaccum delivery 02 (0.07%). No maternal complication was seen in 230 women (91.26%). Accidenatal hemorrhage was seen in 01 (0.39%) which was managed by emergency LSCS. Out of 252 neonates, 183 asymptomatic neonates at birth, 69 needed resuscitation and in which 52 neonates recovered and shifted back to mother and 17 neonates referred and admitted in NICU for MAS in which 07 were recovered and 10 neonates (3.96%) died due to MAS.

Conclusions Intrapartum amnio infusion in meconium stained amniotic fluid by diluting the meconium and by decreasing the cord compression decreases the incidence of foetal distress and there by decreases the rate of caesarean section, these all leads to decrease the incidence of maternal and perinatal morbidity and mortality.