INTRAPARTUM TRANS-CERVICAL AMNIOINFUSION AS ADJUVANT TO CONVENTIONAL MANAGEMENT OF WOMEN HAD RUPTURED MEMBRANES WITH THICK MECONIUM-STAINED AMNIOTIC FLUID.

Objectives: To evaluate maternal and fetal outcome after trans-cervical amnioinfusion (AI) for women presenting by ruptured membranes with thick meconium-stained amniotic fluid (MSAF). Patients & Methods: Eighty-eight women with ruptured membranes and thick MSAF were randomly divided into: Control group received conventional therapy and Study group received AI in addition to conventional therapy. Study outcomes included frequency of cesarean section (CS), assisted vaginal delivery (VD), APGAR score of neonates and frequency of NICU admission. Results: In comparison to control group, frequency assisted VD and CS for fetal distress or failure of labor was significantly lower with AI. Neonates of AI group showed significantly higher 1-min APGAR score, lower frequency of complications or requiring NICU admission. Eleven women of AI group developed tetanic uterine contraction that required stoppage of AI; in 3 women normal uterine tone was regained and infusion was continued and had assisted VD, while in 8 women normal uterine tone failed to be regained and underwent urgent CS. Conclusion: Amnioinfusion significantly increased the chance for getting normal VD, improved variable decelerations of fetal heart rate, reduced neonatal complications and need for NICU admission. Thus, AI may be provided as an essential item during management of such cases.