Role of intrapartum amnioinfusion in meconium-stained amniotic fluid

Abstract

Background: Intrapartum amnioinfusion in meconium-stained amniotic fluid has been known to dilute the meconium and prevent meconium aspiration syndrome (MAS). However, the literature available on intrapartum amnioinfusion is varying. Objective: To assess the neonatal outcomes following intrapartum transcervical amnioinfusion in full-term pregnant women. Methods: This case-control study included pregnant women in active labor, divided into case group (n=63) receiving amnioinfusion and control group (n=63) without amnioinfusion. In the case group, 500 mL of warm, normal saline was infused into the uterine cavity. Both groups were compared for liquor quality, mode of delivery, and neonatal outcomes like APGAR score, resuscitation, meconium presence, MAS, neonatal intensive care unit (NICU) admission, and length of NICU stay. Chi-square test was used to analyze the difference between cases and controls. Results: Mode of delivery was spontaneous vaginal delivery in most cases (71%), with only 19% undergoing cesarean section. APGAR score at 1 min was >7 in cases compared to controls, which was significant (12.69% vs 0%, P=0.005). Resuscitation was required less in cases than controls (9.52% vs 50.79%, P<0.001). Presence of meconium below the vocal cord was more in controls (34.92% vs 4.76%, P=0.003). MAS was observed more in controls (26.98% vs 4.76%, P<0.001)