Intrapartum Amnioinfusion in Meconium Stained Amniotic Fluid: An Update

Abstract

The presence of meconium is associated with an increase in perinatal mortality and morbidity and remains a concern of both obstetriciansand neonatologists. Approximately 8 to 16% of pregnancies may be complicated by the presence of meconium in amniotic fluid. In aboutone third cases, meconium may be present below vocal cords. This poses a risk of meconium aspiration syndrome, which carries amortality rate as high as 25%. Amnioinfusion is a procedure whereby a physiologic solution is infused into the uterine cavity to replace ordilute amniotic fluid. It has been found to relieve umbilical cord compression and dilute meconium, thus reducing the risk of meconiumaspiration. Improved perinatal outcomes have been documented in different studies where intrapartum transcervical amnioinfusion wasadministered to women with meconium stained liquor. It remains a cheap, feasible and good alternative in low resource settings wherefacilities for electronic fetal monitoring are limited.