AMNIOINFUSION AND THE INTRAUTERINE PREVENTION OF MECONIUM ASPIRATION

OBJECTIVE: We evaluated the published literature on the effectiveness of amnioinfusion in reducing meconium below the vocal cords and meconi um aspiration syndrome among infants born to women presenting with mor e than trace meconium-stained fluid. STUDY DESIGN: A literature search was conducted to evaluate clinical trials of amnioinfusion and meconi um aspiration. Trials meeting certain basic design criteria (n = 5), w hich included a prospective study design and blinded assessment of new born outcome, were selected for statistical analyses estimating the av erage effect's size and direction. In total, 247 women with meconium-s tained fluid receiving amnioinfusion and 260 women with meconium-stain ed fluid not receiving amnioinfusion were represented by these trials. RESULTS: Infants born to women with meconium-stained fluid receiving amnioinfusion were less likely to have meconium below the vocal cords (odds ratio 0.13, 95% confidence interval 0.08 to 0.20) and were less likely to have meconium aspiration syndrome (odds ratio 0.20, 95% conf idence interval 0.08 to 0.48) than were infants born to women with mec onium-stained fluid not receiving amnioinfusion. DISCUSSION: Amnioinfu sion appears to be an effective intrauterine intervention for the prev ention of meconium aspiration. Clinicians should consider implementing amnioinfusion in women presenting with thick meconium to prevent intr apartal meconium aspiration in newborns.