Intrapartum amnioinfusion for meconium-stained liquor in developing countries

Area of Science:

• Obstetrics and Gynecology
• Perinatal Medicine
• Maternal-Fetal Medicine

Background:

• Meconium-stained liquor is associated with increased perinatal mortality and morbidity.
• Intrapartum amnioinfusion (AI) has shown promise in reducing adverse outcomes in such cases.
• This study addresses the lack of data on AI in developing countries with high meconium incidence.

Purpose of the Study:

• To evaluate the efficacy of intrapartum amnioinfusion (AI) in reducing Caesarean section rates for fetal distress.
• To determine if AI decreases perinatal morbidity in pregnancies with meconium-stained liquor.
• To assess the clinical relevance and cost-effectiveness of AI in a resource-limited setting.

Main Methods:

• A prospective trial involving 60 term laboring patients with meconium-stained liquor and normal cardiotocography.
• 30 patients received intrapartum amnioinfusion (AI) of 0.9% normal saline (11 L total) under continuous monitoring.
• The control group (30 patients) received standard care.

Main Results:

• The amnioinfusion group exhibited a significantly higher mean umbilical arterial blood pH (7.30 vs. 7.23, P=0.0029).
• Fewer cases of hypoxic ischemic encephalopathy (0 vs. 2) and meconium aspiration syndrome (1 vs. 4) were observed in the AI group.
• While Caesarean sections for fetal distress were lower in the AI group (3 vs. 7), this difference was not statistically significant.

Conclusions:

• Intrapartum amnioinfusion (AI) is an effective method for improving perinatal outcomes in pregnancies with meconium-stained liquor.
• AI demonstrates clinical relevance in reducing fetal distress and has potential cost-effectiveness in high-risk labor wards.
• The study recommends AI as standard practice for managing meconium-stained liquor during labor.