A prospective, randomized evaluation of intrapartum amnioinfusion. Fetal acid-base status and cesarean delivery

Pregnancies with decreased amniotic fluid volume are prediposed to umbilical cord compression and variable fetal heart rate declerations. Intrapartum amnioinfusion has been utilized in an effort to reduce cord compression. Previous studies suggested that amnioinfusion may improve the fetal metabolic state and reduce the incidence of cesarean delivery in selected patients. In this study the hypothesis was tested that intrapartum amnioinfusion will relieve cord compression in pregnancies complicated by oligohydramnios and will result in a reduced incidence of fetal intolerance to labor as well as improved fetal acid-base status at delivery. Thirty-five patients fulfilling the inclusion criteria were randomized to either the control (n = 16) or amnioinfusion treatment group (n = 19). Analysis of the data suggested that the two groups were similar for the perinatal parameters evaluated. No differences were observed in the umbilical artery blood gas analysis or incidence of cesarean section between the two groups. Intrapartum amnioinfusion does not appear to improve the perinatal outcome in pregnancies with oligohydramnios.     

The Collaborative Randomised Amnioinfusion for Meconium project (CRAMP): 2. Zimbabwe

Objective To evaluate transcervical amnioinfusion for meconium stained amniotic fluid during labour.
Design Multicentre randomised controlled trial.
Setting A large urban academic hospital. Electronic fetal heart rate monitoring was not used.
Participants Women in labour at term with moderate or thick meconium staining of the amniotic fluid.
Interventions 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.
Main outcome measures Caesarean section, meconium aspiration syndrome and perinatal mortality.
Results 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).
Conclusions 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.     

Randomised trial of amnioinfusion during labour with meconium stained amniotic fluid

Objective To assess the effect of amnioinfusion during labour with meconium stained amniotic fluid on caesarean section rate and perinatal outcome.
Design Prospective randomised controlled study.
Setting A tertiary care teaching hospital in India.
Population Women in labour at term with meconium stained amniotic fluid.
Methods Two hundred women in labour with ≥37 weeks gestation, single cephalic presentation with moderate or thick meconium were randomised to control and amnioinfusion groups at a 1:1 ratio. Amnioinfusion was performed using 500mL of normal saline over a period of 30 minutes in a study group. The control group received routine care. Both groups had intermittent auscultation of fetal heart rate during labour.
Main outcome measures The primary outcome measure was caesarean section rate. Secondary outcome measures were meconium aspiration syndrome, 1 minute and 5 minute apgar  <7  , hypoxic ischaemic encephalopathy, neonatal intensive care unit admission, meconium at the level of vocal cords.
Results The caesarean section rate in the amnioinfusion group was less than the control group (RR 0.47; 95% CI 0.24–0.93). Amnioinfusion was associated with a significant decrease in the incidence of meconium at the vocal cords (   P = 0.001  ); improvement in 1 minute apgar scores (   P <0.05  ), respiratory distress (   P = 0.002  ) and fewer admissions to nursery compared with the controls. This sample size was inadequate to study the impact on meconium aspiration syndrome.
Conclusion Amnioinfusion in an under resourced labour ward decreases caesarean section rates and fetal morbidity.     

Amnioinfusion in term labor with low amniotic fluid due to rupture of membranes: a new indication

OBJECTIVE: The null hypothesis was that the use of intrapartum amnioinfusion to induce term labor because of premature rupture of membranes when labor was complicated by low amniotic fluid volume due to vaginal loss would not improve fetal heart rate patterns, decrease the incidence of operative delivery, or improve neonatal acid-base status. STUDY DESIGN: 200 term pregnancies with low amniotic fluid due to vaginal loss were randomly chosen to receive intrapartum amnioinfusion or standard obstetric care without amnioinfusion. Fetal heart rate pattern, method of delivery and neonatal acid-base status were compared with Student's t test, chi-squared analysis, Mann-Whitney U- or Fisher's exact test. RESULTS: When amnioinfusion was used, the fetuses had lower rates of variable (74 vs. 91%, P<0.01) or late (26 vs. 58%, P<0.001) decelerations. Spontaneous deliveries were more frequent (77 vs. 59%, P<0.01) and cesarean sections less frequent (3 vs. 10%, P<0.05). Mean umbilical arterial (7.24+/-0.07 vs. 7.21+/-0.08, P<0.01) and venous (7.31+/-0.06 vs. 7.28+/-0.08, P<0.01) pH were significantly higher in newborns with amnioinfusion, and babies in this group had lower rates of neonatal acidemia of arterial (22 vs. 36%, P<0.005) or venous (13 vs. 26%, P<0.005) origin. CONCLUSIONS: Amnioinfusion improved fetal heart rate pattern, lowered the incidence of operative delivery, and improved neonatal acid-base status in term labor complicated by low amniotic fluid due to vaginal loss.     

The Collaborative Randomised Amnioinfusion for Meconium Project (CRAMP): 1. South Africa

Objective To evaluate transcervical amnioinfusion for meconium stained amniotic fluid during labout.
Design Multicentre randomised controlled trial.
Setting Four urban academic hospitals in South Africa. Obstetric surveillance included the use of electronic fetal heart rate monitoring in most cases.
Participants Women in labour at term with moderate or thick meconium staining of the amniotic fluid.
Interventions Transcervical amnioinfusion of 800 mL saline at 15 mL per minute, followed by a maintenance infusion at 3 mL per minute. The control group received routine care. Blinding of the intervention was not possible.
Main outcome measures Caesarean section, meconium aspiration syndrome and perinatal mortality.
Results Caesarean section rates were similar (amnioinfusion group 70/167 vs control group 68/159; RR 0.98, 95% CI 0.76–1.26). The incidence of meconium aspiration syndrome was lower than expected on the basis of previous studies (4/162 vs 6/163; RR 0.67, 95% CI 0.19–2.33). There were no perinatal deaths. There were no significant differences between any of the subsidiary outcomes.
Conclusions This study concurred with three previous trials which found no effect of amnioinfusion for meconium stained amniotic fluid on caesarean section rate, though the pooled data from all identified trials to date show a significant reduction. The findings with respect to meconium aspiration syndrome were inconclusive in this study alone because of the small number of babies affected, but the point estimate of the relative risk was consistent with the finding of a significant reduction in previous studies and with the Zimbabwe arm (CRAMP 2) of this study. Pooled data clearly support the use of amnioinfusion for meconium stained amniotic fluid to reduce the incidence of meconium aspiration syndrome.     

Prophylactic intrapartum amnioinfusion: a randomized clinical trial

Amnioinfusion was performed in a prospective, randomized trial of 60 women in the latent phase of labor with oligohydramnios, as defined by an amniotic fluid index less than or equal to 5.0 cm. All fetuses were at least 37 weeks' gestational age, had normal baseline fetal heart rate variability, and no clinically significant fetal heart rate decelerations at the outset. Subjects in the amnioinfusion group (n = 30) were titrated to and maintained at an amniotic fluid index level greater than or equal to 8.0 cm throughout labor. In the group receiving amnioinfusion, significantly lower rates of meconium passage (p = 0.04), severe variable decelerations (p = 0.04), end-stage bradycardia (p = 0.05), and operative delivery for fetal distress (p = 0.002) occurred. Significantly higher umbilical arterial blood pH values were also noted in the infusion group (p = 0.02). We conclude that prophylactic intrapartum amnioinfusion is an important technique for the reduction of intrapartum morbidity.     

产程中持续内监护下行羊膜腔输液及羊水置换治疗胎儿窘迫

目的 探讨产程中持续内监护下行羊膜腔输及羊水置换,对治疗胎儿窘迫的意义。方法 对产程中出现频发可变减速合并羊水胎粪污染者１３６例,随机分为观察组与对照组各６８例,观察组在持续内监护下行羊膜腔输液或羊水置换。对照组给予吸氧、改变体位、静脉输液等治疗。结果观察组经羊膜腔输液５００￣１０００ｍｌ,ＶＤ波消失或明显改善者占９１．２％,同时对观察组中４８例羊水Ⅱ度以上粪染者行羊水置换,其中３９例羊水国 清亮     

Intrapartum amnioinfusion in women with oligohydramniosis. A prospective randomized trial

BACKGROUND: To evaluate the effects of amnioinfusion in oligohydramniosis. METHODS: During a 20-month period, patients at term with oligohydramniosis (amniotic fluid index less than 5 cm) at Huddinge University and Norrk?ping Hospitals were recruited for a prospective randomized study to evaluate amnioinfusion. Informed consent was obtained from 112 patients who met the entry criteria. Sixty subjects were randomized to amnioinfusion and 52 to the control group. Outcome parameters included fetal heart rate abnormalities, mode of delivery, Apgar score, pH in umbilical artery blood and need for neonatal intensive care. RESULTS: The cesarean section rate was significantly reduced in the amnio-infusion group (29% versus 13%, p=0.043). No difference in time from randomization to delivery was detected between the two groups. The frequency of ominous fetal heart rate tracings with a cervical dilatation of 0-3 cm was the same in the two groups. The frequency of such heart rate patterns after amnioinfusion was significantly lower than in the control group. Neonatal outcome, pH in the umbilical artery blood and need for neonatal intensive care did not differ between the two groups. CONCLUSIONS: The present study confirms the findings of other authors that amnioinfusion effectively reduces the number of cesarean sections in cases of oligohydramniosis.     

Fetal breathing movements in oligohydramnios are not increased by aminoinfusion.

OBJECTIVE: To determine whether fetal breathing movements (FBM) in pregnancies with oligohydramnios change with restoration of amniotic fluid volume. DESIGN: A prospective experimental study. SETTING: Fetal Medicine Unit, tertiary referral hospital. SUBJECTS: 16 women with singleton pregnancies complicated by severe oligohydramnios. INTERVENTIONS: Restoration of amniotic fluid volume by transabdominal amnioinfusion. Controls comprised pregnancies in which infused fluid leaked vaginally, so that oligohydramnios was not corrected. MAIN OUTCOME MEASURES: Change in total breathing movements, change in FBM incidence derived from 40 min recordings immediately before and after amnioinfusion. RESULTS: There was no significant difference in the change in total breathing movements or in the change in incidence of FBM between the 10 pregnancies in which amniotic fluid volume was restored, and the other six in which fluid leaked after infusion and volume was not restored. In both groups, there was no significant change with infusion in number of FBM (mean change -72, 95% CI -218 to +74 in the fluid-retained group and -64, 95% CI -273 to +145 in the fluid-leaked group) and incidence of FBM (median change -2.5%, range -27 to +10 in the fluid retained group and -4.5%, range -34 to +15 in the fluid-leaked group). CONCLUSIONS: This study suggests that restitution of amniotic fluid volume in human pregnancies complicated by severe oligohydramnios does not acutely alter the incidence of FBM. These data support an increasing literature suggesting that impairment of fetal breathing is not the mechanism for oligohydramnios-related pulmonary hypoplasia.     

Meconium concentration and amniotic fluid index influence the outcome of amnioinfusion

BACKGROUND: To determine the usefulness of amnioinfusion as a function of meconium concentration and amniotic fluid index. METHODS: This was a prospective study of 206 pregnant women in whom amniotic fluid was moderately or heavily stained with meconium, according to subjective evaluation. The women were assigned randomly to receive amnioinfusion (n=103) or no amnioinfusion (control group, n=103). The results were compared in women with =/<15 % or >15 % meconium in the amniotic fluid (measured by centrifugation), and in women in whom the amniotic fluid index calculated 60 min after insertion of the amnioinfusion catheter was <10 or =/>10. RESULTS: In women with >15% meconium, amnioinfusion decreased the rate of cesarian sections motivated by fetal distress (2.5% vs 22.2%), and in women with =/<15% meconium, amnioinfusion decreased the presence of meconium below the vocal cords (6.4% vs 25.9%). Greater benefits after amnioinfusion were seen in women with an amniotic fluid index =/>10: the rate of cesarian sections was lower (1.3% vs 13.3%), as was the frequency of meconium below the vocal cords (10.1% vs 33.3%). CONCLUSIONS: Beneficial effects of amnioinfusion were seen in women with high and low concentrations of meconium, and with high and low amniotic fluid indexes. These criteria should therefore not be used to decide whether amnioinfusion is indicated when the amniotic fluid is moderately or heavily stained with meconium.     

应用羊水置换术治疗产时羊水Ⅱ、Ⅲ度胎粪污染

目的 :研究产时应用羊水置换技术对治疗羊水Ⅱ、Ⅲ度胎粪污染的疗效。方法 :选择产时羊水Ⅱ、Ⅲ度胎粪污染的足月单胎头位分娩孕妇 88例 ,其中的 4 4例进行羊水置换术的作为研究组 (A组 ) ;未进行羊水置换操作的另外 4 4例作为对照组 (B组 ) ;另选羊水无胎粪污染的 4 4例孕妇作为实验研究的空白对照组 (C组 )。观察其VD波缓解率、剖宫产率、新生儿血气分析及Apgar评分。结果 :A组变异减速 (VD)波的缓解率高于B组 (6 4.0 0 % ,2 9.17% ,P <0 .0 5 ) ;A组新生儿出生后 1分钟的脐血血气的pH值较B组高 (P <0 .0 5 ) ;A组的剖宫产率 (45 .4 5 % )低于B组(6 8.18% )。结论 :羊水置换对产时羊水Ⅱ、Ⅲ度胎粪污染有显著的疗效 ,可以明显改善新生儿的酸中毒与预后 ,且可以降低剖宫产率。     

Lipid peroxidation in cord blood: a randomised sequential pairs study of prophylactic saline amnioinfusion for intrapartum oligohydramnios

Objective To determine the efficacy of prophylactic intrapartum amnioinfusion in reducing cord arterial lipid peroxide levels in cases of intrapartum oligohydramnios.
Design Sequential randomised pairs trial.
Setting Delivery suite of a teaching hospital, the Chinese University of Hong Kong.
Population Women with singleton, term pregnancy, cephalic presentation, clear amniotic fluid and an amniotic fluid index 5 cm, with a normal intrapartum fetal heart rate tracing within 30 minutes of amniotomy.
Methods Selected patients were randomised either for prophylactic saline amnioinfusion or as control cases. Cord arterial lipid peroxide concentrations and acid base balance were determined at delivery.
Main outcome measures Operative intervention for fetal distress, cord arterial malondialdehyde and organic hydroperoxide levels, pH and base excess.
Results Amnioinfusion was associated with significant reductions in the incidence of operative delivery for fetal distress and in lipid peroxide levels, an increase hi base excess, but no significant alteration in pH.
Conclusions Oligohydramnios in labour is associated with high levels of lipid peroxidation, reflecting cellular damage by release of free radicals following hypoxia reperfusion. Prophylactic intrapartum saline amnioinfusion is an effective technique for the reduction of lipid peroxidation and of the incidence of operative intervention for fetal distress but has no significant effect on overall operative delivery rates.     

Meconium-stained amniotic fluid in labor: a randomized trial of prophylactic amniofusion

OBJECTIVES: To investigate the effect of amnioinfusion in women with meconium-stained amniotic fluid on the rate of cesarian sections and on neonatal morbidity. STUDY DESIGN: A randomized controlled trial. A total of 206 women with meconium-stained amniotic fluid were assigned to receive amnioinfusion via two-way catheter or no amnioinfusion (control group). The catheter was inserted and other treatment was the same in both groups. RESULTS: Amnioinfusion decreased the rate of cesarian sections for fetal distress (RR 0.23, 95% CI 0.07-0.79) and increased mean pH at birth (7.24+/-0.1 versus 7.21+/-0.1, P<0.05). It also decreased the frequency of variable fetal heart rate decelerations (RR 0.74, 95% CI 0.59-0.92), and of meconium below the vocal cords in neonates (RR 0.37, 95% CI 0.19-0.69). CONCLUSIONS: Amnioinfusion improves the neonatal outcome and reduces the frequency of cesarian sections.     

Relief of presumed compression in oligohydramnios: amnioinfusion does not affect umbilical artery Doppler waveforms.

The suggestion that amnioinfusion improves umbilical artery Doppler indices of downstream resistance in oligohydramnios by relieving cord compression was investigated by obtaining waveforms before and immediately after amnioinfusion in 16 pregnancies with severe oligohydramnios. There was no significant difference in the change in umbilical artery pulsatility index (PI) between 11 pregnancies in which amniotic fluid volume was restored (mean delta PI = -0.07, 95% confidence interval -0.17 to +0.07), and 5 pregnancies in which immediate vaginal leakage of infused fluid prevented restitution of amniotic fluid volume. Fetal heart rate did not change significantly in either group. End-diastolic frequencies did not return with restitution of amniotic fluid volume in the 2 pregnancies in which they were absent before infusion (absent in 1, reverse in 1). This study suggests that restitution of amniotic fluid volume in human pregnancies complicated by severe oligohydramnios does not acutely alter the umbilical artery PI.     

Prophylactic intrapartum amnioinfusion for patients with oligohydramnios. A prospective randomized study.

This prospective study evaluated whether prophylactic saline amnioinfusion among patients with amniotic fluid index (AFI) < or = 5.0 cm decreases the incidence of adverse fetal outcomes. Randomization of 53 patients with decreased AFI at term, resulted in 21 patients' receiving prophylactic saline amnioinfusion early in labor, prior to development of an abnormal fetal heart rate tracing. For the treatment group the mean AFI on admission was 3.0 cm, and the postamnioinfusion AFI was 8.9 cm. For 32 comparison (noninfusion) patients, the mean AFI was 2.9 cm; the group consisted of 17 patients randomized to receive no amnioinfusion (control group) and 15 patients who refused to participate in the study. There was no statistically significant difference between the amnioinfused and nonamnioinfused patients with regard to age, parity, gestational age, AFI at admission or duration of first or second stage of labor. Amnioinfusion resulted in no statistically significant reduction in the incidence of recurrent variable decelerations/bradycardia (26.3% vs. 46.6%), intrapartum resuscitation with terbutaline (5.2% vs. 10.0%), cesarean section for fetal distress (9.5% vs. 9.3%), fetal-acidosis (10.5% vs. 12.0%) or Apgar scores < 7 at five minutes (5.2% vs. 0%) in patients with oligohydramnios.     

Role of Intrapartum Transcervical Amnioinfusion in Patients with Meconium-Stained Amniotic Fluid

Objectives

The study was undertaken to evaluate maternal, perinatal outcomes following transcervical intrapartum amnioinfusion in women with meconium-stained amniotic fluid.

Methods

A prospective comparative study was conducted on 100 women with meconium-stained amniotic fluid in labor. Group A: study group (50 cases) received amnioinfusion. Group B: control group (50 cases) did not receive amnioinfusion. FHR monitoring was done using cardiotocography.

Results

Significant relief from variable decelerations was seen in 68.18 % cases in the amnioinfusion group as compared to 7.1 % cases in the control group. 78 % cases who were given amnioinfusion had vaginal delivery as compared to 18 % cases in the control group. Fourteen percent cases in the study group had cesarean delivery as compared to 68 % cases in the control group. Meconium aspiration syndrome was seen in six percent neonates in the study group as compared to 20 % in the control group. Two neonates died in the control group due to meconium aspiration syndrome. There was no maternal mortality or major maternal complication.

Conclusions

Intrapartum transcervical amnioinfusion is valuable in patients with meconium-stained amniotic fluid.     

Predictive value of amniotic fluid and fetal blood cultures in pregnancy outcome in preterm prelabour rupture of membranes.

We carried out a comprehensive prospective study of 26 pregnancies complicated by preterm rupture of the membranes. Microbiological assessment included cultures for aerobic and anaerobic bacteria, Mycoplasmas, Chlamydia, Trichomonas and fungi from: high vaginal and cervical swabs, maternal blood and urine, amniotic fluid and fetal blood on admission and finally, placenta and umbilical cord = after delivery. The group with positive cultures (n 16), was compared with the group with negative cultures = (n 10) in terms of gestational age at labour, latent phase after membrane rupture and fetal and neonatal morbidity and mortality. All patients with positive cultures delivered before 32 weeks and their neonates had evidence of infection. Three intrauterine deaths occurred in this group and 12/13 (86%) of the live neonates were admitted to the neonatal intensive care unit. The 10 (38%) patients of the group with negative cultures delivered after 32 weeks, had no perinatal deaths, and only two were admitted to neonatal intensive care. The median latent phase differed between these two groups (4.5 vs. 53.5 days, P 0.01), as did the median gestational age at labour (28 vs. 36 4 weeks, P 0.01). A positive amniotic fluid or fetal blood culture in the clinical setting of preterm rupture of the membranes indicates labour onset within a few days. Intrauterine infection with fetal sepsis is accompanied by high neonatal infectious morbidity (100%) and mortality (30%).     

Intrapartum transcervical amnioinfusion for meconium-stained amniotic fluid.

OBJECTIVE: To assess the rates of cesarean deliveries and perinatal outcome following intrapartum transcervical amnioinfusion in women with meconium-stained amniotic fluid (MSAF) in a setting with no electronic fetal monitoring or specialized neonatal care. MATERIALS AND METHODS: In this prospective comparative study with 150 women who were in labor and had MSAF, 50 of the women received a transcervical amnioinfusion and the remaining 100 women received standard care. The inclusion criteria were a pregnancy of at least 37 weeks' duration, a single live fetus in cephalic presentation, no major medical or obstetric complications, and no known fetal malformation. The amnioinfusion was performed with 1000 mL of normal saline solution through a red rubber catheter. RESULTS: Amnioinfusion was associated with a significant decrease in the incidence of low Apgar score (<7) at 1 min (12% vs. 47%; relative risk [RR], 0.26; 95% confidence interval [CI], 0.12-0.56); low Apgar score at 5 min (4% vs. 23%; RR, 0.17; 95% CI, 0.04-0.71); and meconium aspiration syndrome (4% vs. 18%; RR, 0.22; 95% CI, 0.05-0.92). There was also a trend towards a lesser incidence of cesarean deliveries (18% vs. 30%; RR, 0.6; 95% CI, 0.31-1.16) and perinatal deaths (4% vs. 13%; RR, 0.31; 95% CI, 0.07-1.31). The incidence of maternal hospital stays longer than 3 days was significantly lower in the amnioinfusion than in the control group (24% vs. 48%; RR, 0.5; 95% CI, 0.29-0.85). There were no major complications related to amnioinfusion. CONCLUSIONS: Intrapartum amnioinfusion for MSAF is a simple, safe, effective, and inexpensive procedure feasible in settings where intrapartum monitoring is limited. It is associated with improved perinatal outcome and could lower cesarean delivery rates in low-resource countries.     

羊膜腔输液治疗在产时应用的临床分析

目的 :分析羊膜腔输液 (amnioinfusion,AI)治疗产时羊水过少、胎膜早破和胎粪性羊水的临床意义。方法 :选择产程中发生胎心异常合并羊水过少、胎膜早破和羊水胎粪污染的孕产妇 1 0 1例 ,随机分为治疗组 51例 ,对照组 50例。治疗组在胎心监护下行羊膜腔输液或羊水置换 ;对照组给予吸氧 ,改变体位 ,静滴 5% Na HCO3等治疗。结果 :治疗组经羊膜腔输液 50 0～ 1 0 0 0 ml,胎心可变减速 (variable deceleration,VD)和长时减速 (period long deceleration,PL D)消失或明显改善 44例 ,有效率占 86 .3% ,明显高于对照组 (2 2 % ) ,两组比较差异有显著性 (P<0 .0 1 )。治疗组 1 9例胎粪性羊水行羊水置换 ,有 1 7例羊水转为清亮或 度混浊。治疗组产程时间比对照组缩短 ,治疗组和对照组剖宫产率分别为 1 3.7%和 34.0 % ,新生儿窒息率分别为 3.9%和 42 .0 % ;对照组胎粪吸入性肺炎 9例 ,新生儿死亡 3例 ,治疗组仅一例发生胎粪吸入性肺炎 ,无新生儿死亡。产褥病率两组比较 ,差异无显著性 (P>0 .0 5)。结论 :羊膜腔输液是治疗产时羊水过少、胎膜早破、胎粪性羊水的有效方法     

The effects of amnioinfused solutions for meconium-stained amniotic fluid on neonatal plasma electrolyte concentrations and pH.

OBJECTIVE: To determine if amnioinfused normal saline or lactated Ringer's solution in cases of meconium-stained amniotic fluid is associated with significant changes on neonatal plasma electrolyte concentrations or pH. STUDY DESIGN: This was a prospective randomized study using normal saline or lactated Ringer's solution for amnioinfusion in women with thick meconium in the amniotic fluid. The control group was composed of women with clear amniotic fluid not receiving amnioinfusion. Cord blood arterial sampling was analyzed for sodium, potassium, and chloride plasma concentrations and pH. The sample sizes allowed for an alpha of 0.05 and power of 0.80. RESULTS: We evaluated 61 cases (20 normal saline solution, 20 lactated Ringer's solution, and 21 control). No significant differences in cord blood arterial plasma concentrations of sodium (p=0.43), potassium (p=0.21), chloride (p=0.68), and pH (p=0.11) were noted. CONCLUSION: Use of normal saline or lactated Ringer's solution for amnioinfusion in meconium-stained amniotic fluid is not associated with changes on neonatal plasma electrolyte concentrations or pH.