Document Detail


Intrapartum amnioinfusion for meconium-stained liquor in developing countries.
MedLine Citation:
PMID:  9481194     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Intrapartum amnioinfusion (AI) has been reported to decrease perinatal mortality and morbidity in women with meconium-stained liquor. Such work has not previously been performed at King Edward VIII Hospital (KEH), in a developing country, where the incidence of meconium-stained liquor is said to be extremely high. OBJECTIVE: To establish whether AI during the intrapartum period for meconium-stained liquor decreases Caesarean section rates for fetal distress and decreases perinatal morbidity. METHOD: Informed consent was obtained from patients in labour who were 3-8 cm dilated, with meconium-staining of the liquor, grades I to III inclusive, and who had a normal cardiotocograph on presentation at term. Sixty patients were included in the trial; 30 had AI. The control group was managed by standard methods. The study group had an amnioinfusion of 0.9% normal saline at 15 ml/min under continuous cardiotocographic monitoring, until a volume of 11 was completed. This was repeated if delivery did not occur within 4 h. RESULTS: The mean pH of umbilical arterial blood was significantly higher in the AI group (7.30 versus 7.23; P = 0.0029). In addition fewer patients in this group developed hypoxic ischaemic encephalopathy (0 versus 2 controls) or meconium aspiration syndrome (1 versus 4 controls). This was not statistically significant. Caesarean section for fetal distress was performed on fewer patients in the AI group (3 versus 7 controls), although this was not statistically significant. CONCLUSION: These results demonstrate that amnioinfusion is an effective technique for improving the perinatal outcome of pregnancies complicated by meconium-stained liquor in labour. The decrease in Caesarean sections for fetal distress, though not statistically significant in this study, has clinical relevance. Furthermore, this study suggests that amnioinfusion is cost effective in a busy, high-risk labour ward unit and consequently should become standard practice in the management of meconium-stained liquor in labour.
Authors:
J Moodley; P Matchaba; A J Payne
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Tropical doctor     Volume:  28     ISSN:  0049-4755     ISO Abbreviation:  Trop Doct     Publication Date:  1998 Jan 
Date Detail:
Created Date:  1998-03-20     Completed Date:  1998-03-20     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  1301706     Medline TA:  Trop Doct     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  31-4     Citation Subset:  IM    
Affiliation:
MRC Pregnancy Hypertension Research Unit, University of Natal, Durban.
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MeSH Terms
Descriptor/Qualifier:
Adult
Amnion*
Developing Countries
Female
Humans
Infant, Newborn
Injections
Meconium Aspiration Syndrome / prevention & control*
Obstetric Labor Complications / therapy*
Pregnancy
Prospective Studies
Sodium Chloride
Chemical
Reg. No./Substance:
7647-14-5/Sodium Chloride

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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