Amnioinfusion for the Prevention of the Meconium Aspiration Syndrome

This large randomized trial showed that, among women in labor who have thick meconium staining of the amniotic fluid, amnioinfusion (infusion of saline into the amniotic cavity) did not reduce the risk of moderate or severe meconium aspiration syndrome, perinatal death, or other major maternal or neonatal morbidity. These data suggest no benefit to amnioinfusion, at least in settings with resources for fetal heart-rate monitoring and resuscitation, as in this trial. Among women in labor who have thick meconium staining of the amniotic fluid, amnioinfusion did not reduce the risk of moderate or severe meconium aspiration syndrome, perinatal death, or other major maternal or neonatal morbidity. Meconium-stained amniotic fluid occurs in 7 to 22 percent of term deliveries, 1 , 2 and the meconium aspiration syndrome complicates 1.7 to 35.8 percent of these deliveries. 3 – 8 The case fatality rate of the meconium aspiration syndrome is reported to range from 5 to 40 percent. 4 , 9 – 11 The meconium aspiration syndrome is believed to result from aspiration of meconium during intrauterine gasping or at the first breath. Prophylactic pharyngeal suctioning and tracheal aspiration have not been shown to reduce the risk of the meconium aspiration syndrome. 4 Amnioinfusion, or transcervical infusion of saline into the amniotic cavity, has been proposed as . . .