Mahomed K, Mulambo T, Woelk G, Hofmeyr G J, Gülmezoğlu A M
Department of Obstetrics and Gynaecology, Harare Hospital, Zimbabwe.
Br J Obstet Gynaecol. 1998 Mar;105(3):309-13. doi: 10.1111/j.1471-0528.1998.tb10092.x.
To evaluate transcervical amnioinfusion for meconium stained amniotic fluid during labour.
Multicentre randomised controlled trial.
A large urban academic hospital. Electronic fetal heart rate monitoring was not used.
Women in labour at term with moderate or thick meconium staining of the amniotic fluid.
Transcervical amnioinfusion of 500 mL saline over 30 minutes, then 500 mL at 30 drops per minute. The control group received routine care. Blinding of the intervention was not possible.
Caesarean section, meconium aspiration syndrome and perinatal mortality.
There was no difference in risk for caesarean section in the two groups (amnioinfusion 9.5% vs control 12.3%; RR 0.84, 95% CI 0.53-1.32). Meconium aspiration syndrome was significantly less frequent in the amnioinfusion group (3.1% vs 12.8%; RR 0.24, 95% CI 0.12-0.48), and there was a trend towards fewer perinatal deaths (1.2% vs 3.6%; RR 0.34, 95% CI 0.11-1.06).
Amnioinfusion is technically feasible in a developing country situation with limited intrapartum facilities. In this study amnioinfusion for meconium stained amniotic fluid was associated with striking improvements in perinatal outcome.
评估分娩期间经宫颈羊膜腔灌注治疗羊水胎粪污染的效果。
多中心随机对照试验。
一家大型城市学术医院。未使用电子胎儿心率监测。
足月分娩且羊水有中度或重度胎粪污染的女性。
在30分钟内经宫颈羊膜腔灌注500毫升生理盐水，然后以每分钟30滴的速度灌注500毫升。对照组接受常规护理。无法对干预措施进行盲法处理。
剖宫产、胎粪吸入综合征和围产期死亡率。
两组剖宫产风险无差异（羊膜腔灌注组9.5%，对照组12.3%；相对危险度0.84，95%可信区间0.53 - 1.32）。羊膜腔灌注组胎粪吸入综合征的发生率显著较低（3.1%对12.8%；相对危险度0.24，95%可信区间0.12 - 0.48），围产期死亡人数有减少趋势（1.2%对3.6%；相对危险度0.34，95%可信区间0.11 - 1.06）。
在产时设施有限的发展中国家情况下，羊膜腔灌注在技术上是可行的。在本研究中，对羊水胎粪污染进行羊膜腔灌注与围产期结局的显著改善相关。
