Amnioinfusion for meconium-stained liquor in labour

Hofmeyr, G Justus; Xu, Hairong

doi:10.1002/14651858.cd000014.pub3

Cited by 31 publications

(21 citation statements)

References 48 publications

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“…African women also had the highest frequency of meconium‐stained liquor. Several studies have documented varying rates of this phenomenon between different racial groups, and a possible cause could be the normal functioning of a mature gastrointestinal tract, because they more often had prolonged pregnancies .…”

Section: Discussionmentioning

confidence: 99%

Higher Risk for Adverse Obstetric Outcomes Among Immigrants of African and Asian Descent: A Comparison Study at a Low‐Risk Maternity Hospital in Norway

Bakken

Skjeldal

Stray‐Pedersen

2015

Birth

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Section: Discussionmentioning

confidence: 99%

Higher Risk for Adverse Obstetric Outcomes Among Immigrants of African and Asian Descent: A Comparison Study at a Low‐Risk Maternity Hospital in Norway

Bakken

Skjeldal

Stray‐Pedersen

2015

Birth

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“…10 However a Cochrane meta-analysis review suggests amnioinfusion to be considered for women with meconium-stained liquor in units with limited facilities for peripartum surveillance, and with no demonstrable reduction in MAS incidence in settings with standard peripartum surveillance. 11 With the recognition of role of chronic in utero hypoxia and associated perinatal asphyxia in pathogenesis of MAS, routine endotracheal suctioning is no longer recommended even in nonvigorous infants with MAS. 12 The decreased mortality rates of newborn babies with MAS from 40% to 25% in recent studies 13,14 ; is directly related to change in obstetric qualifications and use of respiratory supports as exogenous surfactant, nitric oxide and high frequency ventilation.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2020

MIJOPED

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Background: MAS is defined as respiratory distress in a neonate born through meconium-stained amniotic fluid (MSAF) with characteristic radiological findings (hyperinflation and patchy opacities) whose symptoms cannot be explained otherwise. Use of surfactant is also recommended for treatment of MAS. Surfactant is administered intratracheally as either a bolus dose or in dilute form to lavage the lungs in neonates with MAS. In this study, we evaluated role of surfactant therapy in patients of meconium aspirations at our tertiary health care center. Material and Methods: This was a prospective, observational study carried out in neonates with evidence of meconium aspiration syndrome such as presence of meconium stained amniotic fluid or staining of meconium in skin, umbilical cord or nails, presence of meconium below vocal cords and Chest x-ray suggestive of meconium aspiration. Results: In present study 30 cases were included satisfying inclusion and exclusion criteria. In study 18 male and 12 female babies were included. 19 babies were term while 11 babies were pre-term. 21 babies were Appropriate for Gestational Age and 9 babies were small for Gestational Age. Mean gestational age was 37.2 ±1.6 weeks. Mean birthweight was 2190 ± 280 grams. 22 babies were vaginally delivered, 8 delivered by LSCS. Intrapartum 17 babies had fetal heart rate abnormalities. 4 babies needed Chest compressions , 2 needed epinephrine during resuscitation. 2 babies received intubated and on PPV in NICU and 3 babies needed positive pressure ventilation (PPV) at birth,. APGAR scores at 1 min, 5 min and 10 minutes are noted. Average maximum respiratory distress score was 6 ±1.6. 21 babies needed mechanical ventilation. Average duration of mechanical ventilation was 18.5 ± 43.8 hours while average duration of CPAP was 26.4 ± 19.3 hours. 11 ± 8.5 days was average duration of hospital stay. We noted Sepsis, Pneumothorax. PPHN in 4,1 and 1 cases respectively. 22 babies were discharged uneventfully. We noted mortality in 8 cases. Conclusion: Meconium aspiration syndrome is a serious and potentially preventable condition . Surfactant therapy in MAS can reduce the severity of respiratory illness and progressive respiratory failure when used early and judiciously in infants with severe respiratory distress.

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“…Hofmeyr et al (2001) showed that the rates of foetal distress and caesarean section were significantly reduced in amnioinfusion group. [5] Bansal et al [3] found that amnioinfusion in cases of meconium-stained amniotic fluid significantly improved neonatal outcome and reduced caesarean section rate. Bhatia P et al [5] also showed decreased caesarean section rate and decreased incidence of meconium aspiration syndrome.…”

Section: Amnioinfusionmentioning

confidence: 99%

“…[5] Bansal et al [3] found that amnioinfusion in cases of meconium-stained amniotic fluid significantly improved neonatal outcome and reduced caesarean section rate. Bhatia P et al [5] also showed decreased caesarean section rate and decreased incidence of meconium aspiration syndrome. The incidence of low Apgar of <6 at 1', meconium aspiration syndrome, neonatal intensive care unit admission, need for neonatal ventilation and hypoxic ischaemic encephalopathy were significantly reduced in amnioinfusion group.…”

Section: Amnioinfusionmentioning

confidence: 99%

“…A large multicentre trial 2005 by Williams D Frazer et al [11] showed that in clinical settings with standard peripartum surveillance, amnioinfusion in the presence of thick meconium staining of amniotic fluid did not reduce the risk of perinatal death, moderate or severe meconium aspiration syndrome or other serious neonatal disorders. According to Cochrane review 2000, [12] the use of amnioinfusion should be considered for women with meconium-stained amniotic fluid in units with limited facilities for peripartum surveillance. Regarding maternal complication, there was no increased incidence of fever or endometritis in the study group.…”

Section: Amnioinfusionmentioning

confidence: 99%

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Role of Amnioinfusion on Neonatal Outcome in Cases With Meconiumstained Amniotic Fluid

Chandramathy¹,

Kusumam²,

Suma³

et al. 2016

jebmh

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BACKGROUND Amnioinfusion is thought to dilute meconium present in the amniotic fluid and so reduce the risk of meconium aspiration in newborn. AIM The effect of amnioinfusion in meconium-stained amniotic fluid in reducing the incidence of meconium aspiration syndrome, hypoxic ischaemic encephalopathy and perinatal mortality in newborn. MATERIALS AND METHODS The study was carried out in the Departments of Obstetrics and Gynaecology and NICU at Government Medical College, Kozhikode, in a time duration of one year from January 2014 to December 2014. This is a prospective case control study. We have studied 210 antenatal women admitted to the labour room with grade 2/3 meconium-stained amniotic fluid after 36 weeks of gestation. Amnioinfusion was given in 140 cases and 70 cases given standard care. Patients were monitored with electronic foetal heart monitoring and caesarean section was done in case of foetal distress or those who are in early labour. There was no significant difference between study group and control group according to age, parity, gestational age, presence of complications like hypertension/pre-eclampsia, postdated pregnancy, anaemia, etc. RESULTS Foetal heart rate decelerations occurred in 27 out of 140 cases (19%) in the study group and 23 out of 70 (33%) in control group (P <0.05). NEONATAL OUTCOME In our study those who received amnioinfusion, only 19% delivered babies with APGAR <9 at 1' while those who do not received, 36% delivered babies with APGAR <9 at 1' (P value of 0.009). Meconium aspiration syndrome occurred in 2.1% of cases in the infusion group and 11.4% in the non-infusion group (P<0.005). Respiratory distress was markedly reduced in amnioinfusion group 28% compared to 63% in controls (P=0.002). NICU admissions were 64% in control group compared to 22% in amnioinfusion group. Perinatal mortality and hypoxic ischaemic encephalopathy in the infusion group were nil as compared to 7% and 11% in the control group. CONCLUSION Intrapartum amnioinfusion is effective in reducing the incidence of foetal distress and improving the Apgar at 1 minute. The rate of meconium aspiration syndrome, respiratory distress, neonatal intensive care unit admissions and hypoxic ischaemic encephalopathy were also significantly less in the study group. There was no increase in the maternal and neonatal infection rates and complications. Therefore, intrapartum amnioinfusion is a beneficial procedure using simple equipment in the absence of modern electronic foetal monitoring facilities especially in low resource settings.

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Amnioinfusion for meconium-stained liquor in labour

Cited by 31 publications

References 48 publications

Higher Risk for Adverse Obstetric Outcomes Among Immigrants of African and Asian Descent: A Comparison Study at a Low‐Risk Maternity Hospital in Norway

Higher Risk for Adverse Obstetric Outcomes Among Immigrants of African and Asian Descent: A Comparison Study at a Low‐Risk Maternity Hospital in Norway

Untitled

Role of Amnioinfusion on Neonatal Outcome in Cases With Meconiumstained Amniotic Fluid

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