Objectives: To evaluate maternal and fetal outcome after trans-cervical
amnioinfusion (AI) for women presenting by ruptured membranes with
thick meconium-stained amniotic fluid (MSAF).
Patients & Methods: Eighty-eight women with ruptured membranes
and thick MSAF were randomly divided into: Control group received
conventional therapy and Study group received AI in addition to
conventional therapy. Study outcomes included frequency of cesarean
section (CS), assisted vaginal delivery (VD), APGAR score of neonates
and frequency of NICU admission.
Results: In comparison to control group, frequency assisted VD and
CS for fetal distress or failure of labor was significantly lower with AI.
Neonates of AI group showed significantly higher 1-min APGAR
score, lower frequency of complications or requiring NICU admission.
Eleven women of AI group developed tetanic uterine contraction that
required stoppage of AI; in 3 women normal uterine tone was regained
and infusion was continued and had assisted VD, while in 8 women
normal uterine tone failed to be regained and underwent urgent CS.
Conclusion: Amnioinfusion significantly increased the chance for
getting normal VD, improved variable decelerations of fetal heart rate,
reduced neonatal complications and need for NICU admission. Thus,
AI may be provided as an essential item during management of such
cases. |
