Is amnioinfusion effective enough to reduce perinatal mortality?

ABSTRACT

To assess the effects of amnioinfusion for meconium stained liquor on reducing perinatal death. This case control study was conducted in Kalsoom Maternity hospital, Peshawar on singleton pregnancies with cephalic presentation, >37 weeks gestation and meconium stained liquor at admission or during labor, randomized in two groups. Group 1 [study group] received amnioinfusion [normal saline 500mls at room temperature] over a period of 30 minutes at a rate of 10-20 mls/min. Group 2 [control group] did not receive such treatment. Fetal heart monitoring at every 10-15 minutes along with progress of labour plotted on a partogram was recorded. Out of 82 cases, 1 breech and 2 premature were excluded so 79 were left for the study. All were with cephalic presentation and gestation >37 weeks in 73.41% cases and postdates in 26.5% cases. In Group 1 [n=52], 36 [69.2%] had normal vaginal delivery [NVD], 4[7.7%] had outlet forceps delivery, 12[23.1%] had vacuum vaginal delivery and cesarean section rate was 0%. Two [3.8%] newborns were referred to nursery with 1 [1.9%] early neonatal death. In Group 2 [n=27], 6 [22.2%] had NVD, 11[40.7%] delivered with outlet forceps, 10[37.1%] had vacuum vaginal delivery and no cesarean section. Twelve [44.4%] babies were referred to nursery with 2 [7.4%] early neonatal deaths. Amnioinfusion is associated with improvements in perinatal outcome, particularly in settings where facilities for fetal surveillance are limited. The technique appears to be safe, simple and economical