scholarly journals A clinical study on maternal and fetal outcome in pregnancy with oligohydromnios

2018 ◽  
Vol 7 (11) ◽  
pp. 4731
Author(s):  
Chetan Prakash Gupta ◽  
Jaya Choudhary ◽  
Deepika Chahar ◽  
Sapna Kumari Yadav
Keyword(s):  
Birth Asphyxia ◽  
Fetal Monitoring ◽  
Fetal Distress ◽  
Cord Compression ◽  
Fetal Outcome ◽  
Meconium Aspiration Syndrome ◽  
Common Cause ◽  
Increased Risk ◽  
Nicu Admission ◽  
Four Quadrant

Background: Oligohydramnios is associated with various maternal and fetal complication. It’s correlated fetal complications like FGR, increased risk of meconium aspiration syndrome, Birth asphyxia, low APGAR scores and increased congenital abnormalities in fetus. It’s also associated with maternal morbidities in view of operative interventions for delivery. To study effect of oligohydramnios in mother in form of, operative delivery and progress of labour. To study effect of oligohydramnios in fetus in form of fetal compromise i.e.  FGR, fetal distress, altered APGAR score, need for NICU admission. congenital anomaly and perinatal death.Methods: 50 patients with ≥ 28 weeks POG with oligohydramnios, confirmed by ultrasonographic measurement of AFI using four quadrant technique; were selected randomly after fulfilling inclusion and exclusion criteria.Results: Incidence of oligohydramnios were more found in primigravida (56%) in present study. Most common cause of oligohydramnios was idiopathic (62%) followed by PIH (20%). Most common cause of caesarean was fetal distress (23%) either due to cord compression or FGR. oligohydramnios was related to higher rate of Fetal Growth restriction and NICU admission (24%).Conclusions: Oligohydramnios is very common encounter during pregnancy, Because of its frequent occurrence; it demands intensive fetal monitoring and systemic approach to antepartum and intrapartum fetal surveillance. There is increased risk of intrapartum complication, perinatal morbidity, perinatal mortality; thus, the rate of caesarean increasing day by day.one should always know the fine line between vaginal delivery and caesarean section; move ahead with best option without hampering fetal wellbeing and avoid unnecessary operative morbidity.

scholarly journals Clinical study of babies born through meconium stained amniotic fluid

2019 ◽  
Vol 6 (2) ◽  
pp. 491 ◽  
Author(s):  
Shilpasri Y. M. ◽  
Madhurya B.
Keyword(s):  
Amniotic Fluid ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Fetal Monitoring ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Meconium Aspiration Syndrome ◽  
Meconium Aspiration ◽  
Medical College ◽  
Meconium Stained Amniotic Fluid

Background: Meconium stained amniotic fluid has been considered a sign of fetal distress and associated with poor fetal outcome, but others considered meconium passage by fetus is physiological phenomena and produce environmental hazards to fetus before birth. Such magnitude of different opinion was the object behind taking up of this study and aim was to find out incidence and effect of meconium in terms of morbidity and mortality.Methods: Two hundred babies born with meconium stained amniotic fluid considering the inclusion and exclusion criteria from December 2012 to June 2013 in the Department of Paediatrics, Cheluvamba hospital attached to Mysore Medical College and Research Institute, Mysore. Fetal monitoring, mode of delivery, Apgar score, birth weight, resuscitation of baby are noted. All babies followed-up up to 1st week of neonatal life.Results: In present study 200 babies born through meconium stained amniotic fluid was randomly selected-thin 37% and thick 63%. Major complications like birth asphyxia, meconium aspiration syndrome, early neonatal death seen in 5.5% (11 cases), morbidity in 37%, 12.5% in thin and 24.5% in thick MSAF. Causes of death were meconium aspiration syndrome in 3 cases, sepsis in 1 case, pneumonia in 1 case and birth asphyxia in 6 cases.Conclusions: Immediate airway management, need for suction and intubation should be guided by state of newborn rather than presence of meconium. Timely diagnosis and management of meconium stained amniotic fluid may improve fetal outcome. From present study authors conclude that MSAF adversely affect fetal outcome mostly by thick meconium.

scholarly journals Etiological factors, clinical profile and outcome of meconium aspiration syndrome babies

2019 ◽  
Vol 6 (4) ◽  
pp. 1515
Author(s):  
R. Sasivarathan ◽  
A. Logesh Anand
Keyword(s):  
Respiratory Distress ◽  
Tamil Nadu ◽  
Neonatal Intensive Care ◽  
Birth Asphyxia ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Meconium Aspiration Syndrome ◽  
College Hospital ◽  
Severe Respiratory Distress ◽  
Etiological Factors

Background: Meconium staining of amniotic fluid has for long been considered to be a bad predictor of the fetal outcome because of its direct correlation of fetal distress, and increased the likelihood of inhalation of meconium, resultant deleterious effects on the neonatal lung. To evaluate etiological factors and severity of MAS in the study group.Methods: This study was done in the Neonatal intensive care unit of the Department of Paediatrics, Government Mohan Kumaramangalam Medical College Hospital Salem, Tamil Nadu, India in the year 2018. Complete maternal and neonatal details were recorded in to the proforma. Delivery details, resuscitation did were also recorded.Results: In present study, fetal distress was found to be the most common (42.5%) factor associated with MAS followed by PIH (21.6%) and PROM (17%). 22 (9.1%) cases were associated with Postdatism, 18 (7.5%) cases were associated with placental insufficiency. 88 babies had fetal distress (36.6%) prior to delivery. 138 babies had no fetal distress (57.5%).Conclusions: MAS is known to cause severe respiratory distress and Downe’s score ranging between 4-8, usually a few hours after the onset of respiratory distress. Nearly 73.3% of the cases with MAS had birth asphyxia, out of which 30% had severe birth asphyxia. This indicates that passage of meconium can occur in utero, often considered a feature of the stressed fetus. Undoubtedly aspiration had occurred before delivery in these babies.

MECONIUM STAINED LIQOUR AND ITS IMPACT ON PERINATAL OUTCOME

2021 ◽  
pp. 47-49
Author(s):  
Ranjana Sharma ◽  
Manju Agarwal
Keyword(s):  
Prospective Observational Study ◽  
Perinatal Asphyxia ◽  
Birth Asphyxia ◽  
Neonatal Morbidity ◽  
Meconium Aspiration Syndrome ◽  
Morbidity And Mortality ◽  
Medical College ◽  
Increased Risk ◽  
Nicu Admission ◽  
One Year

Background- The occurrence of meconium-stained amniotic uid (MSAF) during labor has long been considered the predictor of adverse fetal outcomes such as meconium aspiration syndrome and perinatal asphyxia, which leads to perinatal and neonatal morbidity and mortality Methods- A Prospective observational study was carried out in Smt. Hira Kunwar Ba Mahila Hospital, Jhalawar attached to Jhalawar Medical College,over one year from January 2020 to January 2021. Total 278 cases taken at random basis having following inclusion criteria Result- MSL is responsible for neonatal morbidity in 15.1% of cases. Rate of neonatal morbidity was higher in thick meconium group (24.9%) as compared to thin meconium group (6.2%) and this difference was statistically signicant. In our study birth asphyxia (5.8%) was the most common complication followed by MAS (4%), Pneumonitis (3.6%) and Sepsis (1.8%). Conclusion- Passage of meconium still remains as an enigma to the obstetrician and equally worries the paediatrician. As shown in the study, thick meconium is associated with increased operative intervention, low apgar score, increased rate of NICU admission and increased risk of neonatal morbidity and mortality as compared to thin meconium.

scholarly journals Postdated pregnancy: its maternal and fetal outcome

2020 ◽  
Vol 9 (8) ◽  
pp. 3223
Author(s):  
Neetu Singh ◽  
Devyani Misra ◽  
Shubhi Srivastava
Keyword(s):  
Uttar Pradesh ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Meconium Aspiration Syndrome ◽  
Perinatal Complications ◽  
Medical Sciences ◽  
Maternal Complications ◽  
Perineal Tear ◽  
Increased Risk ◽  
Fetal Complications

Background: Postdated pregnancy is one of the commonest obstetric conditions. Pregnancy is called term when it lies between 37 weeks to 42 weeks from the last menstrual period. If the pregnancy exceeds 40 weeks it is called as postdated pregnancy. The overall incidence of post term pregnancy is 7% of all pregnancies.Methods: This observational study was carried out in the department of obstetrics and gynecology in Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India from September 2019 to February 2020. Total 100 postdated pregnancy enrolled in the study those willing to participate and fulfilling the inclusion and exclusion criteria. Aim is to assess maternal and fetal outcome in postdated pregnancy.Results: In present study, incidence of postdated pregnancy was found to be 5% and number of normal deliveries was 66 (66%), LSCS were 32 (32%) and 2 (2%) were instrumental delivery. Maternal complications were seen in 14 (14%) cases and fetal complications were found in 23 (23%) cases.Conclusions: Postdated pregnancy was associated with perinatal complications like fetal distress, meconium aspiration syndrome and fetal asphyxia. There was increased risk of obstetrics complications like postpartum haemorrhage (PPH), perineal tear, cervical tear and shoulder dystocia. Management of postdated pregnancy is a challenge to obstetrician and a careful advice and monitoring can alleviate maternal anxiety and untoward complications.

scholarly journals Clinical profile of babies with meconium stained amniotic fluid

2017 ◽  
Vol 5 (10) ◽  
pp. 4319
Author(s):  
Defairlin Ranee ◽  
Deepa S. Phirke
Keyword(s):  
Amniotic Fluid ◽  
Strong Association ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Fetal Distress ◽  
Meconium Aspiration Syndrome ◽  
Clinical Profile ◽  
Meconium Aspiration ◽  
Increased Risk ◽  
Meconium Stained Amniotic Fluid

Background: Meconium staining of amniotic fluid (MSAF) is a relatively common problem occuring in 10-25% of all deliveries. Meconium aspiration syndrome is more common in term babies than in preterm babies with rising frequency along with increase in gestational age of the fetus. Meconium stained amniotic fluid generally indicates sign of fetal distress. The objective of this study was to study clinical profile of meconium aspiration syndrome and the probable risk factors for meconium aspiration syndrome.Methods: It is a prospective observational sectional study conducted in NICU of department of paediatrics of tertiary care centre from 1st January 2015 to 30th June 2016.Results: In this study both sexes were equally affected, majority of the neonates were above 2.5kg and only very few (2 neonates) were less than 1.5kg. majority of the neonates were full term, it was found that there is a significant association between thick MSAF and the development of MAS, it was found that there is a significant association between low APGAR score at 1 minutes and the development of MAS, there is a strong association between thick MSAF and mortality in MSAF babies. Anemia 38 (25%) was the most frequent perinatal risk factor followed by fetal distress 27 (18) and PIH 21 (14%).Conclusions: Newborns with thick MSAF were more likely to develop MAS and thick MSAF and low APGAR at 1 min were associated with high risk of development of MAS. Passage of thick meconium was significantly associated with severe birth asphyxia and carried a bad prognosis with increased risk of development of meconium aspiration syndrome and hypoxic ischaemic encephalopathy.

scholarly journals The role of color Doppler and spectral flow analysis in the management of pregnancy induced hypertension

2017 ◽  
Vol 5 (4) ◽  
pp. 1300
Author(s):  
Nehal S. Diwanji ◽  
Alpesh D. Pancholi ◽  
Mona Shastri
Keyword(s):  
Color Doppler ◽  
Flow Analysis ◽  
Birth Asphyxia ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Ductus Venosus ◽  
Spectral Flow ◽  
Pregnancy Induced Hypertension ◽  
Induced Hypertension ◽  
Nicu Admission

Background: Nearly one third intrauterine death of normally formed singleton fetuses are associated with IUGR coexisting with or without pregnancy induced hypertension (PIH). Abnormal fetal circulation is considered a major factor in fetal growth restriction, both as a cause and an indicator. Doppler ultrasound is a relatively new technique which merits investigations as a screening method for IUGR and PIH as both are associated with placental vascular pathology. The development of Doppler ultrasonographic technology, particularly during last 10 years, has provided an opportunity to obtain both qualitative and quantitative assessment of maternal and fetal hemodynamics using a non-invasive method. Objectives were to assess the role of color Doppler and spectral flow analysis in the management of pregnancy induced hypertension.Methods: It was a prospective observational study in which 50 pregnant women were taken as cases with pregnancy induced hypertension and 25 as matched controls without any high-risk factor. All patients were examined for colour Doppler spectral flow analysis. Detailed USG results in the form of maturity by biparietal diameter, head circumference, femoral length, abdominal circumference, liquor, and expected fetal weight were measured and noted. Doppler study of umbilical artery, fetal middle cerebral artery, both maternal uterine arteries and ductus venosus was carried out. Parameters in the form of resistive index (RI), pulsatility index (PI) and systolic/diastolic ratio (S/D) of all four arteries were taken. In ductus venosus waveform, changes in the ‘a’ wave were noted. All participants were followed up from the point of the recruitment up to the time of delivery. At the time of delivery, the mode of delivery, any complications, the Apgar score, weight of the baby, birth asphyxia and admission in NICU were noted.Results: The number of patients with PIH were highest in the age group of 21-25 years [n=31 (62%)]. IUGR of fetus occurred in 74% of the cases with PIH, while no any patients with IUGR fetus among the control group. 92% patients among uterine notches showed abnormal fetal outcome in the form of low birth weight, preterm delivery, LSCS for fetal distress, birth asphyxia or NICU admission of the neonate. Out of total 37 (74%) IUGR cases, 24 (65%) cases had fetoplacental Doppler abnormality. Out of total 6 cases with absent end-diastolic flow (AEDF) 4 cases had abnormal fetal outcome and 2 cases had delivered still-born babies. 20 out of 30 cases had abnormal fetal middle cerebral arterial Doppler (MCA) PI, out of which 19 patients had abnormal fetal outcome. 23 cases had abnormal CPR, out of them 20 (87%) cases had abnormal outcome and only 3 cases had normal fetal outcome. The parameters at the time of delivery are number of cases with delivery before 37 weeks of GA (63.3%), SGA babies (70%), LSCS for fetal distress (43.3%), and NICU admission (43.3%).Conclusions: Examining the maternal vessels using Doppler ultrasound, it is possible to determine the risk of complication developing in the course of pregnancy long before clinical signs of preeclampsia appear, so that therapeutic measures may be undertaken early.

scholarly journals Perinatal outcome of meconium stained amniotic fluid in pregnancy beyond 37 weeks

2021 ◽  
Vol 10 (2) ◽  
pp. 624
Author(s):  
Joshi D. Suyajna ◽  
Jayasakthi G. ◽  
Rajeswari Rai ◽  
Ruksar Banu
Keyword(s):  
Amniotic Fluid ◽  
Caesarean Section Rate ◽  
Neonatal Resuscitation ◽  
Birth Asphyxia ◽  
Fetal Distress ◽  
Meconium Aspiration Syndrome ◽  
Meconium Aspiration ◽  
Increased Risk ◽  
Meconium Staining ◽  
Meconium Stained Amniotic Fluid

Background: To identify the frequency of meconium aspiration syndrome among the total births who suffered from meconium staining of amniotic fluid, to find out risk factors during pregnancy, therapies and various complications associated with this condition and their effects on perinatal outcome.Methods: This was a retrospective study of 252 antenatal patients delivered at Department of DNB-OBG District hospital Bellary during the year January 2019 to December 2019 with gestational age between 37-40 weeks with singleton pregnancies and cephalic presentation were included in the study.Results: The Caesarean section rate for fetal distress was 96.6% in patients with meconium stained amniotic fluid (MSAF). Meconium aspiration syndrome (MAS) was found in3.93% babies. APGAR score at 1 minute <7 was found in 25 cases (9.84%).Conclusions: Meconium stained amniotic fluid is associated with increased need for neonatal resuscitation, increased risk of birth asphyxia, meconium aspiration syndrome, hospital admission and mortality. So identification of pregnant woman at risk of passage of meconium during labour would allow intensive fetal surveillance and early intervention which might lead to reduction in neonatal adverse outcome.

scholarly journals A prospective case control study of the effects of oligohydramnios on fetomaternal outcome in mothers with term pregnancy in a rural medical college

2018 ◽  
Vol 7 (11) ◽  
pp. 4706
Author(s):  
Dipak Mandi ◽  
Sayantan Sen ◽  
Vasundhara Goswami
Keyword(s):  
Demographic Data ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Case Control ◽  
Control Group ◽  
Case Group ◽  
Perinatal Complications ◽  
Medical College ◽  
Increased Risk ◽  
Nicu Admission

Background: The aim of the current study was to assess the fetomaternal effects of oligohydramnios on term pregnancies in a rural tertiary care setup.Methods: A perspective case control hospital-based trial was conducted at Burdwan Medical College and Hospital for a period of one year. Pregnancies at term (37-42 weeks) were included in the study. 103 patients with sonographically diagnosed oligohydramnios were included in the case group. The control group comprised of 103 mothers at term with normal liquor volume. Demographic data and fetomaternal outcome parameters were assessed and compared.Results: There was increased incidence of fetal and perinatal complications including low birth weight, birth asphyxia and NICU admission. There were more perinatal deaths in the case group compared to the control group. Induction of labour, operative delivery, meconium stained liquor and incidence of preeclampsia were also increased in mothers with low AFI.Conclusions: Oligohydramnios is associated with an increased risk of labour and perinatal complications. Adequate antenatal surveillance and intranatal monitoring coupled with correction of underly-ing factors is the mainstay of management.

scholarly journals No Take Home Baby After Caesarian Birth for Foetal Distress in Women with Risk

2018 ◽  
Vol 3 (1) ◽  
Keyword(s):  
Risk Factors ◽  
Neonatal Outcome ◽  
Meta Analysis ◽  
Birth Asphyxia ◽  
Fetal Distress ◽  
Cord Compression ◽  
High Rate ◽  
Neonatal Deaths ◽  
Fetal Ecg ◽  
Foetal Asphyxia

Sometimes interventions are done for the baby in women with risks but it turns out to be unnecessary caesarian section (CS). However it may be delayed decision and / or delayed execution of intervention, CS too, with no take home baby. While lack of adverse outcome reflected that the decision was not for a compromised foetus, still birth or asphyxiated baby at birth meant delayed decision and / or execution. Recent studies revealed an estimated 9.04 million perinatal deaths related to birth asphyxia. Of them 1.02 million were intrapartum deaths leading to still births, many after CB for foetal concern. Birth asphyxia is a significant global health problem, responsible for around 1.2 million neonatal deaths each year worldwide [1-3]. Those who survive often suffer from a range of disorders. Chauhan et al. conducted, a meta analysis comprising of 169 articles and 37 reports and concluded that the overall risk of prompt CB for fetal concern was 3.1 % (43,340 of 13,98,9740 cases) [4,5]. From time to time several hospital based studies have proved the role of various antepartum or intrapartum maternal & foetal risk factors which lead to foetal asphyxia. It is known that some disorders which could cause foetal asphyxia are obvious during pregnancy, some are labour related, be it mother or baby. Kaye reported association of primiparity, anaemia, hypertensive disorders of pregnancy, foetal growth restriction, malpresentation, antepartum haemorrhage, premature rupture of membranes, prematurity, fever, oxytocin augmentation of labour, umbilical cord prolapse, as risk factors ,with complex interplay between factors which predispose foetuses to poor outcome, due to decreased oxygenation, ACOG reported that foetal hypoxemia which if not compensated or corrected in time progressed to birth asphyxia and even death, either in utero or immediately after birth [6,7]. Gaffineet and James have reported, intrapartum hypoxia complicating around 1% of labours, resulting in foetal / neonatal deaths in 0.5/1000 pregnancies and cerebral palsy in 1 in 1000 cases diagnosed after swift delivery for clinically diagnosed “fetal distress’’ [8]. Earlier Murphy et al had suggested that reduced uterine perfusion uteroplacental vascular disease, low fetal reserve foetal asphyxia, foetal sepsis and cord compression with other gestational and antepartum factors could affect the fetal response which needed to be known. However diagnosis of FD also has to be correct and timely [9]. Cardiotocography (CTG) has been criticized for unnecessary high rate of operative delivery [10-12]. In the study by Roy, non-reassuring fetal heart rate (FHR) detected by CTG did not correlate well with neonatal outcome [13]. In the era of defensive practices, ‘play safe’ attitude results in high CS rate for non-reassuring FHR. The concept of detecting fetal acidosis, using fetal scalp blood appeared attractive, but practical difficulties in carrying it out restricted its use [14,15]. Roy et al suggested that since non-reassuring FHR detected by CTG did not correlate well with adverse neonatal outcome and resulted in unnecessary CS, fetal ECG needed to be introduced in addition to conventional CTG, wherever possible [13]. There are many such issues about timely appropriate authentic diagnosis and action.

scholarly journals Perinatal outcome associated with oligohydramnios in third trimester

2016 ◽  
Vol 6 (1) ◽  
pp. 72 ◽  
Author(s):  
Kamlesh R. Chaudhari ◽  
Kushagra R. Chaudhari ◽  
Omkar M. Desai
Keyword(s):  
Birth Weight ◽  
Amniotic Fluid ◽  
Apgar Score ◽  
Neonatal Morbidity ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
High Rate ◽  
Research Centre ◽  
Meconium Staining ◽  
Nicu Admission

Background: We aimed to evaluate the effect of Oligohydramnios on fetal outcome in terms of fetal distress, Meconium staining of amniotic fluid, birth weight, Apgar score of newborn babies, NICU admission, early neonatal morbidity and mortality.Methods: This was a prospective study of 156 antenatal patients booked at K. J. Somaiya medical college and research centre during the year January 2012 to December 2013 with gestational age between 30-40wks with AFI<5cms with intact membranes were analyzed for perinatal outcome.Results: The Caesarian section rate for fetal distress was 41% in patients with Oligohydramnios. Meconium staining of amniotic fluid was found in 30.7% patients. APGAR score at 5 minutes <7 was found in 6 patients (3.8%).Conclusions: Oligohydramnios has significant correlation with Caesarean section for fetal distress and low birth weight babies. Oligohydramnios is associated with high rate of pregnancy complication and increased perinatal morbidity and mortality. Oligohydramnios is a frequent occurrence demand careful evaluation, intensive parental counseling, fetal surveillance and proper antepartum and intrapartum care.

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