Fetal and Maternal Effects of Amnioinfusion Applied during Delivery in Oligohydramniotic Meconium- Stained Pregnancies

Abstract

Objectives: This study aimed to investigate the fetal and maternal effects of amnioinfusion applied during delivery in meconium-stained pregnancies. Methods: Sixty singleton pregnancies with cervical dilation >2 cm, normal fetal heart rate, and amniotic fluid index below 5 cm, at or beyond 37 weeks of gestation were included in this study. Thirty patients were randomly assigned to the amnioinfusion group and the other 30 patients formed the control group. Results: After amnioinfusion was applied to both groups, maternal fever, fetal tachycardia, fetal heart rate tracings, operation rates, Apgar scores, presence of meconium under vocal cords and oropharynx, and incidence of meconium aspiration syndrome (MAS) were evaluated. Patients requiring operative intervention due to fetal distress were 3% (1/30) in Group 1 and 37% (11/30) in Group 2, which was statistically significant (p=0.002). Apgar scores below 7 at 1 min in Group 1 was 10% (3/30), while it was 40% (12/30) in Group 2, which was statistically significant (p=0.01). In Group 1, no infants had an Apgar score below 7 at 5 min, while in Group 2, 24% (7/30) of infants had an Apgar score below 7, which was statistically significant (p=0.01). Meconium under the oropharynx was found to be 24% (7/30) in Group 1 and 70% (21/30) in Group 2, while the presence of meconium under the vocal cords was 6% (2/30) in Group 1 and 44% (13/30) in Group 2, and both of these differences were statistically significant (p=0.0006, p=0.002). The incidence of MAS observed in Group 1 was 0 and 20% (6/30) in Group 2, which was statistically significant (p=0.02). Conclusion: Amnioinfusion is one of a series of interventions aimed at reducing mortality and morbidity related to meconium aspiration. Although our clinical study showed positive results, randomized controlled trials, and meta-analyses are needed to clarify whether routine amnioinfusion provides clinical benefits, and prospective randomized controlled studies should be supported.