Neonatal outcomes of non-vigorous neonates with meconium-stained amniotic fluid before and after change in tracheal suctioning recommendation

1995 ◽

Vol 2 (5) ◽

pp. 210-212 ◽

Cited By ~ 12

Author(s):

Shelley Chapman ◽

Patrick Duff

Keyword(s):

Amniotic Fluid ◽

Mode Of Delivery ◽

Case Control ◽

Host Immune System ◽

Retrospective Case ◽

Before And After ◽

Accelerated Growth ◽

Meconium Staining ◽

Meconium Stained Amniotic Fluid ◽

Growth Of Bacteria

Objective: The goal of this study was to determine if meconium staining of the amniotic fluid (MSAF) is a marker for chorioamnionitis.Methods: In a retrospective, case-control investigation, we studied 100 patients with MSAF. Each patient was matched with a control who delivered during the same period but did not have MSAF. Subjects and controls were matched for age, parity, gestational age, mode of delivery, duration of rupture of membranes (ROM), length of internal monitoring, and number of examinations before and after ROM. The incidence of chorioamnionitis in controls and study patients was compared. The diagnosis of chorioamnionitis was based on clinical examination.Results: Thirteen of the 200 patients [6.5%, 95% confidence interval (CI), 2.5–10.5%] developed chorioamnionitis. Of the 100 women with MSAF, 10 (10%, 95% CI, 4–16) were infected compared with only 3 controls (3%, 95% CI, 0–6, P = 0.04). The odds ratio (OR) for this comparison was 3.3, and the 95% CI was 1.02–10.63.Conclusions: MSAF is associated with an increased frequency of chorioamnionitis. Several factors could explain this association. Infection may cause fetal stress, leading to the release of meconium. MSAF may enhance the growth of bacteria by providing a rich medium of essential nutrients or growth stimulants. MSAF also may impair the host immune system so that chemotaxis or phagocytosis is diminished, thus allowing accelerated growth of microorganisms.

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MECONIUM‐STAINED AMNIOTIC FLUID: WHAT ARE THE NEONATAL OUTCOMES?

Journal of Paediatrics and Child Health ◽

10.1111/jpc.14410_88 ◽

2019 ◽

Vol 55 (S1) ◽

pp. 84-84

Keyword(s):

Amniotic Fluid ◽

Neonatal Outcomes ◽

Meconium Stained Amniotic Fluid

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Association of gestational age, Apgar score and neonatal outcomes in newborns with meconium stained amniotic fluid

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20192755 ◽

2019 ◽

Vol 6 (4) ◽

pp. 1563

Author(s):

Preeti Garg ◽

Devendra Barua ◽

Shruti Saxena

Keyword(s):

Amniotic Fluid ◽

Gestational Age ◽

Apgar Score ◽

Tertiary Care ◽

Neonatal Outcomes ◽

Control Group ◽

Study Group ◽

Increased Risk ◽

The Mean ◽

Meconium Stained Amniotic Fluid

Background: Infants born with meconium stained fluid are at increased risk of fetal hypoxia, evidenced by increased rates of abnormalities indicated by fetal monitoring in labor, low neonatal Apgar scores, and fetal deaths. The study is conducted to determine association of gestational age, Apgar score and neonatal outcomes in newborn born with meconium stained amniotic fluid in tertiary care centre of central India.Methods: The study was conducted over a period of 2 years from January 2012 to January 2014 in Department of Pediatrics, Sri Aurobindo Medical College and Hospital, Indore, Madhya Pradesh, India. One hundred newborns with meconium stained amniotic fluid (study group) and one hundred newborns with clear amniotic fluids (control group) were studied in this period. Gestational age, Apgar score and neonatal outcomes were compared among two groups.Results: The mean gestational age in study group was 38.89±1.14 weeks and in control group was 38.59±0.99 weeks. The mean Apgar score at 1 min was 5.80±1.59 in study group and in the control group was 7.86±0.35. 32 babies in meconium stained liquor had hypoxia of which 11 had respiratory distress, 11 required mechanical ventilation (MAS 08, sepsis 03), 2 newborns had HIE stage 2 and 5 patients died. The above findings suggest higher gestational age, lower Apgar score and poor neonatal outcomes are associated with meconium stained liquor.Conclusions: The study depicts significant co-relation with higher gestational age, lower Apgar at 1 and 5 minutes and poor neonatal outcome in babies with meconium stained amniotic fluid.

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Time needed to intubate and suction a manikin prior to instituting positive pressure ventilation: a simulation trial

European Journal of Pediatrics ◽

10.1007/s00431-020-03759-5 ◽

2020 ◽

Vol 180 (1) ◽

pp. 247-252

Author(s):

Francesco Cavallin ◽

Giulia Res ◽

Chiara Monfredini ◽

Nicoletta Doglioni ◽

Paolo Ernesto Villani ◽

...

Keyword(s):

Confidence Interval ◽

Amniotic Fluid ◽

Clinical Setting ◽

Positive Pressure Ventilation ◽

Mean Difference ◽

Positive Pressure ◽

Endotracheal Suctioning ◽

Pediatric Residents ◽

Tracheal Suctioning ◽

Meconium Stained Amniotic Fluid

AbstractTracheal suctioning in non-vigorous newborn delivered through meconium-stained amniotic fluid (MSAF) is supposed to delay initiation of positive pressure ventilation (PPV), but the magnitude of such delay is unknown. To compare the time of PPV initiation when performing immediate laryngoscopy with intubation and suctioning vs. performing immediate PPV without intubation in a manikin model. Randomized controlled crossover (AB/BA) trial comparing PPV initiation with or without endotracheal suctioning in a manikin model of non-vigorous neonates born through MSAF. Participants were 20 neonatologists and 20 pediatric residents trained in advanced airway management. Timing of PPV initiation was longer with vs. without endotracheal suctioning in both pediatric residents (mean difference 13 s, 95% confidence interval 8 to 18 s; p < 0.0001) and neonatologists (mean difference 12 s, 95% confidence interval 8 to 16 s; p < 0.0001). The difference in timing of PPV initiation was similar between pediatric residents and neonatologists (mean difference − 1 s, 95% confidence interval − 7 to 6 s; p = 0.85).Conclusions: Performing immediate laryngoscopy with intubation and suctioning was associated with longer—but not clinically relevant—time of initiation of PPV compared with immediate PPV without intubation in a manikin model. While suggesting negligible delay in starting PPV, further studies in a clinical setting are warranted.Registration: clinicaltrial.gov NCT04076189. What is Known:• Management of the non-vigorous newborn delivered through meconium-stained amniotic fluid remains still controversial.• Tracheal suctioning in non-vigorous newborn delivered through meconium-stained amniotic fluid is supposed to delay initiation of positive pressure ventilation, but the magnitude of such delay is unknown.What is New:• Performing immediate ventilation without intubation was associated with shorter—but not clinically relevant—time of initiation of ventilation compared to immediate laryngoscopy with intubation and suctioning in a manikin model.• Further studies in a clinical setting are warranted.

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Is meconium-stained amniotic fluid in near-term infants associated with increased rates of adverse maternal and neonatal outcomes?

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2006.10.708 ◽

2006 ◽

Vol 195 (6) ◽

pp. S197

Author(s):

Susan Tran ◽

Anjali Kaimal ◽

Michael Kuzniewicz ◽

Aaron Caughey

Keyword(s):

Amniotic Fluid ◽

Neonatal Outcomes ◽

Term Infants ◽

Maternal And Neonatal Outcomes ◽

Near Term ◽

Meconium Stained Amniotic Fluid

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Risk of Neonatal Short-Term Adverse Outcomes Associated with Noninfectious Intrapartum Hyperthermia: A Nested Case-Control Retrospective Study

American Journal of Perinatology ◽

10.1055/s-0039-1698837 ◽

2019 ◽

Author(s):

Hao Zhu ◽

Jiangnan Wu ◽

Yijia Yang ◽

Xiaotian Li ◽

Rong Hu

Keyword(s):

Risk Factors ◽

Retrospective Study ◽

Amniotic Fluid ◽

Induction Of Labor ◽

Adverse Outcomes ◽

Neonatal Outcomes ◽

Positive Pressure ◽

Neonatal Infections ◽

Adverse Neonatal Outcomes ◽

Meconium Stained Amniotic Fluid

Abstract Objective Aim of this study was to identify risk factors for adverse neonatal outcomes in neonates born to mothers with noninfectious intrapartum hyperthermia. Study Design A retrospective study was conducted of 460 singleton deliveries diagnosed with noninfectious intrapartum hyperthermia. Logistic regression was used to estimate the association between ante- and intrapartum risk factors and neonatal outcomes. Results The 460 singleton pregnant women were 19 to 43 years of age. They developed an intrapartum temperature of ≥37.5°C somewhere between 340/7 to 414/7 weeks' gestation; 437 (95%) were nulliparous. Meconium-stained amniotic fluid was associated with positive pressure ventilation or intubation ventilation (odds ratio [OR] = 5.940, 95% confidence interval [CI]: 2.038–17.318), birth depression (OR = 6.288, 95% CI: 2.273–17.399), and wet lung (OR = 2.747, 95% CI: 1.322–5.709). Induction of labor with artificial rupture of membranes (AROM; OR = 2.632, 95% CI: 1.325–5.228) was associated with neonatal infections. Maternal temperature ≥ 38°C was associated with neonate's artery blood gas pH < 7.3 (OR = 2.366, 95%CI: 1.067–5.246) and wet lung (OR = 2.909, 95% CI: 1.515–5.586). Maternal elevated C-reactive protein (CRP) was associated with neonatal infections (OR = 1.993, 95% CI: 1.260–3.154) and wet lung (OR = 2.600, 95% CI: 1.306–5.178). Conclusion Meconium-stained amniotic fluid, induction of labor, maternal temperature ≥ 38°C, and elevated CRP during labor were risk factors for adverse neonatal outcomes.

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