Efficacy of Amnioinfusion for meconium stained liquor in labour in a rural hospital

Abstract

Incidence of meconium stained liquor is about 9.5% -25% of all deliveries. Incidence of placental and body staining is 5 - 10%. It probably indicates previous episode of intrauterine hypoxia or a state of compensated fetal distress. 5 - 12 % develop Meconium aspiration syndrome, a life threatening respiratory disorder which results from aspiration of meconium into the lungs and its perinatal morbidity and mortality ranges from 4 % - 40 %. prevention of meconium aspiration syndrome remains the major objective for obstetricians and neonatologists. Hence this study of amnioinfusion and its effect on maternal and perinatal morbidity and mortality in women with meconium stained liquor during labour was conducted. Objectives: To find out the efficacy of amnioinfusion in meconium stained liquor during labour . To study neonatal morbidity and mortality by assessing Apgar score at birth and NICU admission. Material And Methods : In this study 60 pregnant women in labour with meconium stained liquor were included .They underwent amnioinfusion and fetal outcome by apgar score at 1 min and 5 min , admission to NICU were taken into consideration and analysed. Results: In our study 76.5% had high risk factors like PIH ,IUGR , anaemia , 36% had fetal heart variations and 42.8% needed NICU admission. 60% of the cases were multigravida with bishop's score >6 . All had full term normal delivery. Other 40% were primigravidas of which 30% had LSCS and 10% had instrumental deliveries. Average birth weight was 3kg. 41% babies had 0-6 apgar score at 1 min and 59% had 7-10 apgar at 5 minutes. depressed babies were admitted in NICU. There was 5% perinatal mortality in our study. Conclusion: Amnioinfusion in active labour is associated with improvement in perinatal outcome most probably due to dilution in meconium and relief of oligohydramnios. There was a reduction in the rate of caeserean section for fetal distress and overall meconium aspiration syndrome and NICU admissions thereby