Publication:

Role of amnioinfusion in meconium stained liquor in relation to fetal outcome

Background Meconium aspiration syndrome complicates 1.7 to 35.8% of deliveries. The meconium aspiration syndrome is believed to result from aspiration of meconium during intrauterine gasping or at the time of first breath. Transcervical infusion of saline into amniotic cavity or amnioinfusion has been proposed as a method to reduce the risk of the meconium aspiration syndrome.

Methods The study was conducted in Department of Obstetrics and gynecology in collaboration with the department of paediatrics, Era’s Lucknow Medical College, Lucknow, India in the study period of 18 months. It was a prospective case control study. A total number of 80 patients were enrolled for the purpose of study. The patients were randomly divided into two groups. Control group (n=40) those who received standard treatment (i.e. labor analgesia, maternal nutrition and record of progress of labor) and Study group (n=40) patients who were managed by giving amnioinfusion in addition to the standard treatment. Both groups were compared in terms of fetal outcome. Data so obtained was subjected to statistical analysis using statistical package for Social Science Version 15.0.

Results Majority of babies of control group (n=22, 55%) have Apgar score at 1 minute was <7 whereas majority of babies born to mothers of study group (n=27, 67.5%) have apgar scores at 1 minute was ≥7.    Resuscitative measures were required in majority of control group babies (n=22, 55%) as compared to only 13 (32.5%) babies of study group. Meconium aspiraton syndrome was present in 12 babies (30%) of control group as compared to only 4 babies (10%) of study group. Rate of neonatal death was higher in control group (5%) as compared to study group (2.5%). A total of 25 (62.5%) babies required NICU admission in control group and 15 (37.5) babies in study group.

Conclusions The findings in present study indicates that aminoinfusion in a well-equipped tertiary care unit reduces the rate of caesarean section significantly while at the same time influences the neonatal outcome in terms of better Apgar score, reduced need of resuscitative measures and reduced neonatal morbidity.