Abstract：
This study aimed to reassess the effect of prophylactic transcervical amnioinfusion for intrapartum meconium-stained amniotic fluid on meconium aspiration syndrome and other adverse neonatal and maternal outcomes.
From inception to November 2021, a systematic search of the literature was performed in PubMed, Embase, Web of Science, and Scopus databases and gray literature sources.
We identified randomized controlled trials of patients with intrapartum moderate to thick meconium-stained amniotic fluid that evaluated the effect of amnioinfusion on adverse neonatal and maternal outcomes.
Of note, 2 reviewers independently abstracted data and gauged study quality by assigning a modified Jadad score. Meconium aspiration syndrome constituted the primary outcome. The secondary outcomes were meconium below the cords, Apgar scores of <7 at 5 minutes, neonatal acidosis, cesarean delivery, cesarean delivery for fetal heart rate abnormalities, neonatal intensive care unit admission, and postpartum endometritis. This study calculated the odds ratios with 95% confidence intervals for categorical outcomes and weighted mean differences with 95% confidence intervals for continuous outcomes.
A total of 24 randomized studies with 5994 participants met the inclusion criteria. The overall odds of meconium aspiration syndrome was reduced by 67% in the amnioinfusion group (pooled odds ratio, 0.33; 95% confidence interval, 0.21-0.51). Except for postpartum endometritis, amnioinfusion was associated with a significant reduction in all secondary outcomes.
Our study found that the use of intrapartum amnioinfusion in the setting of meconium-stained amniotic fluid significantly reduces the odds of meconium aspiration syndrome and other adverse neonatal outcomes.
From inception to November 2021, a systematic search of the literature was performed in PubMed, Embase, Web of Science, and Scopus databases and gray literature sources.
We identified randomized controlled trials of patients with intrapartum moderate to thick meconium-stained amniotic fluid that evaluated the effect of amnioinfusion on adverse neonatal and maternal outcomes.
Of note, 2 reviewers independently abstracted data and gauged study quality by assigning a modified Jadad score. Meconium aspiration syndrome constituted the primary outcome. The secondary outcomes were meconium below the cords, Apgar scores of <7 at 5 minutes, neonatal acidosis, cesarean delivery, cesarean delivery for fetal heart rate abnormalities, neonatal intensive care unit admission, and postpartum endometritis. This study calculated the odds ratios with 95% confidence intervals for categorical outcomes and weighted mean differences with 95% confidence intervals for continuous outcomes.
A total of 24 randomized studies with 5994 participants met the inclusion criteria. The overall odds of meconium aspiration syndrome was reduced by 67% in the amnioinfusion group (pooled odds ratio, 0.33; 95% confidence interval, 0.21-0.51). Except for postpartum endometritis, amnioinfusion was associated with a significant reduction in all secondary outcomes.
Our study found that the use of intrapartum amnioinfusion in the setting of meconium-stained amniotic fluid significantly reduces the odds of meconium aspiration syndrome and other adverse neonatal outcomes.
摘要：
目的：本研究旨在重新评估预防性经宫颈羊膜液输注对胎粪吸入综合征和其他不良新生儿和产妇结局的影响。
方法：从成立到2021年11月，在PubMed中对文献进行了系统的搜索，Embase,WebofScience,和Scopus数据库和灰色文献来源。
方法：我们确定了产时中度至厚厚胎粪染色羊水患者的随机对照试验，该试验评估了羊膜输注对新生儿和产妇不良结局的影响。
方法：值得注意的是，2名评审员独立提取数据并通过分配修改后的Jadad评分来衡量研究质量。胎粪吸入综合征是主要结果。次要结果是脐带以下的胎粪，Apgar在5分钟时得分<7，新生儿酸中毒,剖宫产,剖宫产胎儿心率异常，新生儿重症监护病房入院，和产后子宫内膜炎。这项研究计算了分类结果的95％置信区间的比值比，以及连续结果的95％置信区间的加权平均差。
结果：共有24项随机研究，5994名参与者符合纳入标准。羊膜输液组的胎粪吸入综合征的总体几率降低了67%（合并的优势比，0.33；95%置信区间，0.21-0.51）。除了产后子宫内膜炎,羊膜输注与所有次要结局的显著降低相关.
结论：我们的研究发现，在胎粪污染的羊水环境中使用产时羊膜液输注可显著降低胎粪吸入综合征和其他不良新生儿结局的几率。
方法：从成立到2021年11月，在PubMed中对文献进行了系统的搜索，Embase,WebofScience,和Scopus数据库和灰色文献来源。
方法：我们确定了产时中度至厚厚胎粪染色羊水患者的随机对照试验，该试验评估了羊膜输注对新生儿和产妇不良结局的影响。
方法：值得注意的是，2名评审员独立提取数据并通过分配修改后的Jadad评分来衡量研究质量。胎粪吸入综合征是主要结果。次要结果是脐带以下的胎粪，Apgar在5分钟时得分<7，新生儿酸中毒,剖宫产,剖宫产胎儿心率异常，新生儿重症监护病房入院，和产后子宫内膜炎。这项研究计算了分类结果的95％置信区间的比值比，以及连续结果的95％置信区间的加权平均差。
结果：共有24项随机研究，5994名参与者符合纳入标准。羊膜输液组的胎粪吸入综合征的总体几率降低了67%（合并的优势比，0.33；95%置信区间，0.21-0.51）。除了产后子宫内膜炎,羊膜输注与所有次要结局的显著降低相关.
结论：我们的研究发现，在胎粪污染的羊水环境中使用产时羊膜液输注可显著降低胎粪吸入综合征和其他不良新生儿结局的几率。
