Amnioinfusion for meconium stained liquor at Chris Hani Baragwanath Hospital: a secondary analysis of local data from an international multicentre randomized trial

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dc.contributor.authorNguekeng, Etienne
dc.date.accessioned2021-12-15T20:55:07Z
dc.date.available2021-12-15T20:55:07Z
dc.date.issued2021
dc.descriptionA research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in fulfilment of the requirements for the degree of Master of Medicine in Obstetrics and Gynaecology, 2021en_ZA
dc.description.abstractBackground: Passage of meconium-stained amniotic fluid (MSAF) during labour is associated, not only with fetal hypoxia, but with subsequent meconium aspiration syndrome. Amnioinfusion has been proposed as an effective treatment for reducing the risk of fetal or neonatal meconium aspiration, by diluting and washing out the meconium from the amniotic fluid in the uterus during labour. Objective: This study was done to determine the effect of amnioinfusion on mode of delivery, meconium aspiration syndrome, and neonatal outcome at Chris Hani Baragwanath Hospital. Methods: This was a secondary analysis of data collected at Chris Hani Baragwanath Hospital, as part of a large international Canada-based multicentre randomized controlled trial of amnioinfusion versus standard management (without amnioinfusion) in labours associated with passage of MSAF. The secondary data set of all women randomized at Chris Hani Baragwanath Hospital was analysed, comparing women who received amnioinfusion with those who received standard management. Chi-squared tests, and Fisher’s exact tests where applicable, were used to make statistical comparisons. Results: Data were available for analysis in 496 women. Standard management was done in 241 women, and amnioinfusion in 255. There were no statistically significant differences in caesarean section rate (38.0% v. 40.2% respectively; P= 0.61) or caesarean section rate for fetal distress (6.7%v.7.9%; P=0.60). There were no statistically significant differences in proportion of five-minute Apgar scores less than 7 (1.2% v.1.2%; P=1.0), neonatal admission (1.2% v. 1.6%; P=0.72), and neonatal ventilation (0.4% v 0.8%; P= 0.62). There was one neonatal death, from the amnioinfusion group. The neonatology care professionals were unable to diagnose meconium aspiration with confidence in all cases and some neonatal ward data were missing, therefore results of this outcome were not available. Conclusion: There were no significant differences in adverse outcomes between the amnioinfusion and standard treatment groups, although the sample size was not powered to determine statistically significant differences for uncommon outcomes such as meconium aspiration syndrome, neonatal ventilation and neonatal death. However, the incidence of adverse outcomes was low. There appeared to be no benefit for amnioinfusion in this secondary data analysis from Chris Hani Baragwanath Hospitalen_ZA
dc.description.librarianCKen_ZA
dc.facultyFaculty of Health Sciencesen_ZA
dc.identifier.urihttps://hdl.handle.net/10539/32333
dc.language.isoenen_ZA
dc.titleAmnioinfusion for meconium stained liquor at Chris Hani Baragwanath Hospital: a secondary analysis of local data from an international multicentre randomized trialen_ZA
dc.typeThesisen_ZA
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