scholarly journals Evidence of both foetal inflammation and hypoxia–ischaemia is associated with meconium aspiration syndrome

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kyoko Yokoi ◽  
Osuke Iwata ◽  
Satoru Kobayashi ◽  
Mizuho Kobayashi ◽  
Shinji Saitoh ◽  
...  
Keyword(s):  
Cord Blood ◽  
Univariate Analysis ◽  
Meconium Aspiration Syndrome ◽  
Meconium Aspiration ◽  
Acid Glycoprotein ◽  
Protein Levels ◽  
Reactive Protein ◽  
Blood Ph ◽  
Histopathologic Findings ◽  
Meconium Stained Amniotic Fluid

AbstractFoetal hypoxia–ischaemia is a key trigger of meconium aspiration syndrome (MAS). However, many neonates develop MAS without evidence of hypoxia–ischaemia, suggesting the presence of covert but important risk variables. We evaluated the association of MAS with clinical variables, placental histopathologic findings, and inflammatory biomarkers at birth. Of 1336 symptomatic and asymptomatic term singleton neonates with meconium-stained amniotic fluid, 88 neonates (6.6%) developed MAS. Univariate analysis showed that MAS development was associated with low 1- and 5-min Apgar scores, low cord blood pH, funisitis, higher α1-acid glycoprotein levels, and higher haptoglobin levels (all p < 0.001 except for p = 0.001 for haptoglobin). Associations of MAS with caesarean delivery (p = 0.004), premature rupture of the membranes (p = 0.006), chorioamnionitis (p = 0.007), and higher C-reactive protein levels (p = 0.008) were lost when adjusted for multiple comparisons. The final multivariate model to explain MAS development comprised lower cord blood pH (odds ratio [OR] 0.58; 95% confidence interval [CI] 0.47–0.73; p < 0.001), funisitis (OR 2.45; 95% Cl 1.41–4.26; p = 0.002), and higher α1-acid glycoprotein levels (OR 1.02; 95% Cl 1.01–1.03; p = 0.001). Our data from a large cohort of neonates suggested that intrauterine inflammation is one of the key independent variables of MAS development, together with foetal hypoxia–ischaemia.

scholarly journals Meconium Stained Amniotic Fluid – A Potential Predictor Of Meconium Aspiration Syndrome

1970 ◽  
Vol 28 (1) ◽  
pp. 3-6 ◽  
Author(s):  
P Swain ◽  
A Thapalial
Keyword(s):  
Amniotic Fluid ◽  
Apgar Score ◽  
Multiple Logistic Regression Analysis ◽  
Univariate Analysis ◽  
Significant Risk ◽  
Neonatal Morbidity ◽  
Meconium Aspiration Syndrome ◽  
Meconium Aspiration ◽  
Prolonged Labour ◽  
Meconium Stained Amniotic Fluid

Objective: To identify potential predictors of Meconium Aspiration Syndrome (MAS) in pregnancies complicated by meconium-stained amniotic fluid (MSAF) & to review the incidence, morbidity and mortality of Meconium Aspiration Syndrome (MAS). Methods: In the period of 2003 to 2006,175 pregnancies with thick meconium-stained AF were delivered; of these, 15 neonates developed MAS and 160 did not. The two groups were compared retrospectively according to maternal findings, pregnancy outcome, and neonatal complications, using univariate analysis (P < 0.05 considered significant) and stepwise multiple logistic regression analysis to identify independent significant factors for prediction of MAS. Results: Incidence of MSAF was 13.97% and that of MAS was 8.57%. All deliveries associated with thick MSAF had developed MAS. 40% mothers were associated with PROM & prolonged labour. Most common & significant risk factors associated with MAS were increased gestational age, increased cesarean section (LSCS) & low Apgar scores at 1 minute and 5 minute. Mortality rate was 6.66% & mechanical ventilation was used in only 1(6.66%) case. Conclusion: MAS are associated with higher incidence of LSCS, lower 1 minute & 5 minute Apgar score & higher gestational weeks. 40% mothers were associated with PROM & prolonged labour. The neonatal morbidity & mortality is significantly more frequent in relation to thick meconium stained amniotic fluid. Specific delivery room resuscitation procedure, early diagnosis & proper management can prevent development of MAS as well as morbidity & mortality. Key words: Meconium Stained Amniotic Fluid, Meconium Aspiration Syndrome and Apgar Score.   DOI = 10.3126/jnps.v28i1.1397 J. Nepal Paediatr. Soc. Vol.28(1) p.3-6

scholarly journals Study of early neonatal outcomes in babies delivered through meconium-stained amniotic fluid in a rural teaching hospital

2021 ◽  
Vol 8 (4) ◽  
pp. 642
Author(s):  
Venkatesh Dhannaram ◽  
Sumathi Kotapuri ◽  
Sudharshanraj Chitgupikar
Keyword(s):  
Respiratory Distress ◽  
Amniotic Fluid ◽  
Admission Rate ◽  
Meconium Aspiration Syndrome ◽  
Multiple Gestation ◽  
Meconium Aspiration ◽  
Emergency Cesarean ◽  
Nicu Admission ◽  
A Prospective Study ◽  
Meconium Stained Amniotic Fluid

Background: When the fetus is in a state of stress meconium is passed presence of meconium in amniotic fluid is potentially a serious Sign of fatal compromise, frequency of meconium strained amniotic fluid ranges from 5-22%. MSAF results in higher rate of cesarean delivery, NICU admission rate, respiratory distress, PPHN and neonatal death. The primary objectives of the study were to estimate the incidence of Meconium aspiration syndrome & Respiratory distress among babies born through meconium-stained amniotic fluid (MSAF) along with studying the outcomes at the end of 7 days.Methods: This was a prospective study undertaken in mediciti institute of medical sciences, Ghanpur Medchal Mandal from Jan 2018 to June 2019. Data was collected in a predetermined proforma after institutional ethical committee clearance and appropriate informed consent.Results: During this period 1972 neonates were delivered of which 216 babies were born through MSAF. 18 were excluded for non-cephalic presentation, multiple gestation or congenital anomalies.198 babies were included in the study (96 male and 102 female). 18 neonates (10.2%) needed resuscitation at birth. 85 (42.9%) had thick MSAF. 43 of them developed respiratory distress (21.7%). 10 babies were ventilated. Seizures, hyperbilirubinemia, thrombocytopenia were more common among babies with thick MSAF. Mortality was 1%.Conclusions: Thick meconium-stained amniotic fluid was associated with low Apgar score, higher rate of emergency cesarean section and meconium aspiration syndrome. Primigravida mothers, maternal hypothyroidism and oligohydramnios were important risk factors associated with MAS.

scholarly journals A study of maternal risk factors and the perinatal outcome in meconium stained amniotic fluid in central referral hospital

2019 ◽  
Vol 8 (11) ◽  
pp. 4146
Author(s):  
Kapil Singh Niranjan ◽  
Pesona Grace Lucksom
Keyword(s):  
Risk Factors ◽  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Significant Risk ◽  
Birth Asphyxia ◽  
Meconium Aspiration Syndrome ◽  
Meconium Aspiration ◽  
Maternal Risk ◽  
Prolonged Labor ◽  
Meconium Stained Amniotic Fluid

Background: Meconium staining of amniotic fluid (MSAF) is a significant risk factor for the subsequent development of meconium aspiration syndrome (MAS), respiratory distress and eventual respiratory failure in neonates. To learn more about the risk factors and outcomes associated with MSAF, a prospective case control study was conducted. The objective of the study was to study various maternal risk factors associated with MSAF and to study the outcome of neonates born through MASF and to compare the perinatal outcome in patients with thick and thin meconium stained amniotic fluid.Methods: A hospital based prospective case control study was conducted comparing pregnant women with meconium stained (cases) amniotic fluid with pregnant women having clear liquor (control), 200 in each arm. Singleton pregnancies complicated with MASF were included in the cases group on the basis of predefined inclusion criteria. Various risk factors, mode of delivery, outcome of neonates and perinatal outcome in babies born through thick and thin meconium stained amniotic fluid was studied.Results: Out of 200 patients who had MSAF 114 patients (57%) had thick meconium stained liquor while remaining 86 patients (43.00%) had thin meconium stained amniotic fluid. Post-maturity, pregnancy induced hypertension; oligohydramnios and prolonged labor were found to be statistically significant risk factors for MSAF. Nonreactive non-stress test and Need for cesarean section was more common in women with MSAF as compared to women with clear liquor (p <0.05). Common morbidities in neonates were Birth asphyxia (15%) followed by meconium aspiration syndrome (10%) and hypoxic ischemic encephalopathy (15%).Conclusions: Meconium stained amniotic fluid is more commonly associated with post-maturity, pregnancy induced hypertension, oligohydramnios and prolonged labor low APGAR score and higher incidence of birth asphyxia and NICU admissions. Appropriate management of neonates with meconium aspiration syndrome is crucial to prevent neonatal mortality.

scholarly journals Perinatal Outcome Associated with Meconium Stained Amniotic Fluid In Pregnancy

2015 ◽  
Vol 4 (2) ◽  
pp. 44-49 ◽  
Author(s):  
Nasrin Begum ◽  
Sharmeen Mahmood ◽  
Salma Akhter Munmun ◽  
MS Haque ◽  
KN Nahar ◽  
...  
Keyword(s):  
Birth Weight ◽  
Amniotic Fluid ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Perinatal Death ◽  
Mode Of Delivery ◽  
Neonatal Resuscitation ◽  
Meconium Aspiration Syndrome ◽  
Meconium Aspiration ◽  
Meconium Stained Amniotic Fluid

Objectives: To evaluate perinatal outcome associated with meconium stained amniotic fluid in pregnant women.Methods: It was a prospective cross sectional study, conducted in the Department of Obstetrics and Gynecology in Bangabandhu Sheikh Mujib Medical University, Dhaka, from January 2013 to December 2013. Total 50 pregnant women admitted in the labour ward for delivery with meconium stained amniotic fluid were the study population. Singleton pregnancy of more than 34 weeks duration was included and pregnancy with APH, breech presentation, congenital malformation of fetus, IUD were excluded from the study. Out of 50 patients two did not provide all the information needed to analyze the data and hence were excluded. Outcome Variables were gestational age, antenatal checkup, medical diseases of mother (HTN, Diabetes mellitus, Heart disease), obstetric complication (oligohydramnios, prolonged labour), mode of delivery, neonatal details (weight of the baby in kg, APGAR scoring at 1 min & 5 min), neonatal resuscitation, admission in neonatal ICU(NICU), neonatal complications (RDS, MAS, Neonatal death).Results: Over half (52.1%) of the neonates needed resuscitation and 54.2% admitted in ICU. About 90% of the neonates had normal birth weight and only 10.4% were of low birth weight. 14.6% of the neonates developed meconium aspiration syndrome and 10.4% respiratory distress syndrome. Neonatal jaundice and neonatal sepsis were observed in 4.2% neonates each. Four neonates (8.3%) died early in the neonatal life, while 1 (2.1 %) was still-born. Low APGAR score (<7) at 1 and 5 minutes of birth was found in 64.7% and 52.9% of the cases respectively with thick meconium stained amniotic fluid as opposed to 25.8% and 16.1% of the cases respectively having thin meconium stained amniotic fluid (p = 0.008 and p = 0.007 respectively). Thick meconium was significantly associated with meconium aspiration syndrome (p = 0.003). Neonates needing immediate resuscitation and admission in ICU was staggeringly higher in the former group than those in the later group (p = 0.002). The incidence of perinatal death was significantly higher in patients with thick meconium stained amniotic fluid than that in patients with thin meconium ( p= 0.021).Conclusion: Meconium stained amniotic fluid was associated with low APGAR score, higher incidence of MAS, ICU admission and perinatal death.J. Paediatr. Surg. Bangladesh 4(2): 44-49, 2013 (July)

scholarly journals Study of risk factors and perinatal outcome in meconium stained deliveries from a district of Uttar Pradesh, India

2018 ◽  
Vol 7 (9) ◽  
pp. 3605
Author(s):  
Richa Rathoria ◽  
Ekansh Rathoria ◽  
Utkarsh Bansal ◽  
Madhulika Mishra ◽  
Ila Jalote ◽  
...  
Keyword(s):  
Risk Factors ◽  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Birth Asphyxia ◽  
Meconium Aspiration Syndrome ◽  
Pregnancy Induced Hypertension ◽  
Meconium Aspiration ◽  
Fetal Bradycardia ◽  
Induced Hypertension ◽  
Meconium Stained Amniotic Fluid

Background: The objective is to identify the risk factors of Meconium stained deliveries and evaluate the perinatal outcomes in Meconium Stained deliveries.Methods: This prospective observational study included those pregnant women who had completed 37 weeks of gestation, with singleton pregnancies with cephalic presentations and with no known fetal congenital anomalies. Among these, we selected 110 cases with Meconium stained amniotic fluid and they were compared with 110 randomly selected controls.Results: Regular antenatal visits were seen in 22.73 % of the cases while 77.27% cases had no previous visit. Majority of cases were primigravida and gestational ages of >40 weeks was seen in 55.45 % cases. 19.09% cases had meconium staining among pregnancies complicated with pregnancy induced hypertension, as compared to those among controls (5.45%). Fetal heart rate abnormalities were seen in 29.09% cases, and statistically significant fetal bradycardia was seen in cases. Caesarean section rates were nearly double in cases (54.55%). Poor perinatal outcome was found in cases as seen in results by low Apgar score (<7) at 1 minute and 5-minute, higher incidence of birth asphyxia, Meconium Aspiration Syndrome and increased NICU admission as compared to that among controls.Conclusions: Meconium stained amniotic fluid is more commonly associated with higher gestational age >40 weeks, pregnancy induced hypertension and fetal bradycardia, increased cesarean section rates, low APGAR score and higher incidence of birth asphyxia and NICU admissions. Meconium aspiration syndrome was associated with early neonatal death.

scholarly journals Study of respiratory complications and outcome in meconium stained deliveries

2019 ◽  
Vol 6 (3) ◽  
pp. 940
Author(s):  
Omprakash S. Shukla ◽  
Swapna S. T.
Keyword(s):  
Statistical Significance ◽  
Pulmonary Hemorrhage ◽  
Meconium Aspiration Syndrome ◽  
P Value ◽  
Respiratory Complications ◽  
Apgar Scores ◽  
Meconium Aspiration ◽  
A Prospective Study ◽  
Complications And Mortality ◽  
Meconium Stained Amniotic Fluid

Background: To study the development of respiratory complications in the form of meconium aspiration syndrome (MAS), persistent pulmonary hypertension of newborn (PPHN), pulmonary hemorrhage and pneumothorax in neonates born through meconium stained liquor.Methods: It was a prospective study conducted during the period of February to October 2018. All live babies associated with meconium stained liquor were included.Results: Total 606 neonates with meconium stained amniotic fluid (MSAF) were enrolled. Chance of meconium passage was more after 37wk of gestation, in birth weight >2.5 kg and in AGA babies. The rate of LSCS was higher in MSAF group. MAS developed in 28% cases, out of which 42.9% expired. PPHN developed in 6.9% cases, out of which 80% expired. 100% mortality was there in babies with pulmonary hemorrhage. Apgar scores <7 is significantly associated with the development of respiratory complications. 22.8% of vigorous babies and all non-vigorous babies developed respiratory complications showing statistical significance with P-value of <0.00001. Mortality in MSAF was 12%. All babies who expired had severe meconium aspiration syndrome. 83.9% of the patients stayed for <7 days in the hospital. All of the expiry except one occurred within 7 days of life due to development of respiratory complications.Conclusions: MSAF is associated with the development of respiratory complications and mortality in neonates. Non-vigorous babies and the babies with Apgar scores <7 at birth are more prone to developing respiratory complications. Most of the MSAF babies were discharged and mortality was more in patients with respiratory complications.

Sign in / Sign up

Export Citation Format

Share Document