PETHIDINE (MEPERIDINE) ADMINISTRATION IN DELIVERIES WITH MECONIUM STAINED AMNIOTIC-FLUID - EFFECTS ON FETAL-OUTCOME AND RESPIRATORY-DISTRESS

Objective The aim of the study was to evaluate the effects of material pethidine administration on fetal outcome and incidence of neonatal r espiratory distress in deliveries with meconium stained amniotic fluid (MAF). Study design Between 1989 and 1992, 849 live infants had MAF. For pain relief during labor 214 women received pethidine 50-150 mg i. m. The control group included 401 infants with MAF, who were not expos ed to sedatives, analgesics, and anesthetics during labor, Fetal cord pH, Apgar 1 min (A1), Apgar 5 min (A5), and incidence of respiratory d istress were compared retrospectively between the groups. Statistics a nd calculations were done by means of uni- and multivariate analyses. Results The presence of thickend MAF increased significantly the risk of low A1, low A5, low arterial cord pH. and the incidence of respirat ory distress (p = 0.003, = 0.0003, = 0.016, = 0.000). Infants with thi ckend MAF, low Al, and low fetal cord pH proved to have an exceedingly high risk of respiratory distress. The application of pethidine (0 mg , 50 mg, 100-150 mg) does not discriminate the variables as arterial c ord pH A1, A5, and the incidence of respiratory distress significantly . However the medium cord pH values of infants without pethidine (7.27 , s = 0.075) and with 100-150 mg pethidine (7.25, s = 0.078) were sign ificantly different (p = 0.0006). The incidence of arterial pH <7.10 d id not differ significantly in cases with different pethidine doses. C onclusions Thickend MAF is an obstetric hazard with small but signific antly increased risks for poor fetal outcome and neonatal respiratory distress. This study failed to identify additional neonatal risks enge ndered by use of pethidine in cases of MAF.