The impact of a policy of amnioinfusion for meconium-stained amniotic fluid
| Autor: | Naji K. Aswad, Baha M. Sib Ai, Brian M. Mercer, Ihab M. Usta |
|---|---|
| Rok vydání: | 1995 |
| Předmět: |
Adult
medicine.medical_specialty Amniotic fluid medicine.medical_treatment Sodium Chloride Amnioinfusion Meconium Pregnancy Meconium aspiration syndrome Humans Medicine Infusions Parenteral Fetal Death reproductive and urinary physiology Meconium stained amniotic fluid business.industry Obstetrics Incidence (epidemiology) Infant Newborn Pregnancy Outcome Obstetrics and Gynecology Amniotic Fluid Delivery Obstetric medicine.disease Respiration Artificial Occult Meconium Aspiration Syndrome Apgar Score Female business |
| Zdroj: | Obstetrics & Gynecology. 85:237-241 |
| ISSN: | 0029-7844 |
| DOI: | 10.1016/0029-7844(94)00385-q |
| Popis: | To evaluate the impact of an amnioinfusion (AI) policy for thick or moderate meconium-stained amniotic fluid (AF) on neonatal outcome, specifically meconium-aspiration syndrome and its complications.We reviewed maternal and neonatal charts of 937 vertex, singleton pregnancies complicated by moderate or thick meconium-stained AF during a 3-year period. The patients were divided into groups according to whether AI was performed. Demographic characteristics, risk factors, mode of delivery, pregnancy outcome, and neonatal complications, including meconium-aspiration syndrome, were analyzed.Four hundred forty patients (47%) received AI (AI group); 497 (53%) did not, for the following reasons: imminent delivery (310 patients), occult meconium (141), or emergency cesarean delivery (46) (no-AI group). Our study did not show any reduction in the incidence of 5-minute Apgar scores of 7 or less (8 versus 7%), meconium below the vocal cords (28 versus 29%), meconium aspiration syndrome (4.5 versus 3.8%), ventilation requirement (4.3 versus 2.4%), or neonatal death (0.7 versus 0.2%) in the AI and no-AI groups, respectively. The AI group had a higher incidence of fetal heart rate abnormalities in labor (48 versus 31%, P.05), instrumental delivery (15 versus 8%, P.05), cesarean delivery (28 versus 17%, P.001), and endometritis (21 versus 13%, P = .004).With the policy of routine AI for moderate or thick meconium-stained AF, AI was not clinically feasible in 53% of the cases. We were unable to demonstrate any improvement in neonatal outcome in those who received AI for moderate or thick meconium. |
| Databáze: | OpenAIRE |
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