Intrapartum amnioinfusion as a preventive measure for meconium aspiration syndrome; a randomized controlled study

Background The present study has been done to evaluate the role of amnioinfusion in patient with moderate to thick meconium under conditions of limited intrapartum foetal surveillance. Methods We performed a prospective randomised controlled study during July 2006 to December 2007 in which 200 pregnant women in labour at 37 or more weeks of gestation were stratified according to the presence of moderately or thickly meconium stained liquor and then randomly assigned to amnioinfusion or to standard care. The primary outcome measure was caesarean section rate and meconium below vocal cords of the baby. Secondary outcome measures included 1-minute and 5-minute apgar scores, meconium aspiration syndrome, admission to NICU and perinatal mortality. Results Meconium aspiration syndrome occurred in 8% of controls and in no patient from aminoinfusion group. Conclusions For women in labour who have thick meconium staining of the amniotic fluid, amnioinfusion reduces the risk of moderate or severe meconium aspiration syndrome and perinatal morbidity. Caesarean section rate for foetal distress, apgar score <5 at one minute and meconium aspiration syndrome were also significantly less frequent in the study group compared to those in the control group.