scholarly journals Comparative analysis of maternal and fetal outcome in meconium stained amniotic fluid and clear liquor in primigravida

2020 ◽  
Vol 9 (2) ◽  
pp. 482
Author(s):  
Deepali S. Kapote ◽  
Apeksha M. Mohite ◽  
Anam Syed
Keyword(s):  
Heart Rate ◽  
Amniotic Fluid ◽  
Apgar Score ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Birth Asphyxia ◽  
Fetal Outcome ◽  
Control Group ◽  
Singleton Pregnancy ◽  
Meconium Staining

Background: The present study was undertaken to evaluate the significance of MSAF and its fetal outcome in parturients.Methods: A total of 121 pregnant women who had completed more than 37 weeks of gestation with live singleton pregnancy, spontaneous onset of labor and at term with adequate pelvis were included in the study. All (121) low risk primigravida with MSAF were studied to identify maternal and fetal outcome and compared with equal number of cases with clear amniotic fluid. Meconium stained cases were clinically classified into two groups- thin (54 cases) and thick (67 cases). MSAF on spontaneous or artificial rupture of membranes were monitored with fetal heart rate abnormality, 1- and 5-minutes Apgar score, NICU admissions and neonatal complications as outcome variables.Results: Overall incidence of meconium staining of AF during labour was 7.71%. The common fetal heart rate abnormalities i.e. bradycardia was seen in 36% in MSG. Apgar score of less than 7 was observed in MSG at 5 minutes in 5% of cases, in thick group. Major neonatal complication was birth asphyxia in MSG (18.18%) that was more in thick MSG (14.87%). MAS were observed in 6 cases in thick and 4 cases in thin meconium stained cases. NICU care was required in 18% cases in MSG and in control group it was required in 7% cases. Neonatal morbidity was more in newborn with thick meconium group (52%) compared to thin meconium group (20%).Conclusions: The present study confirmed that meconium staining of amniotic fluid adversely influences the fetal outcome.

scholarly journals Fetal heart rate patterns in patients with thick meconium staining of amniotic fluid and its association with perinatal outcome

2017 ◽  
Vol 6 (3) ◽  
pp. 1030 ◽  
Author(s):  
Dharna Desai ◽  
Nandita Maitra ◽  
Purvi Patel
Keyword(s):  
Heart Rate ◽  
Amniotic Fluid ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Caesarean Section Rate ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Neonatal Morbidity ◽  
P Value ◽  
Meconium Staining

Background: This study assesses the role of abnormal fetal heart rate tracing patterns in patients with thick meconium staining of the amniotic fluid and its association with perinatal outcomes.Methods: Prospective unmatched case-control study on 2 groups of 136 subjects each- cases had thick MSAF and controls had clear liquor with abnormal fetal heart rate tracings on cardiotocography.Results: Gestational age (GA) >40 weeks, was found to have a significant association with MSAF (p value 0.01556 CI 95%). Premature Rupture of membranes at term (PROM) showed a significant association with MSAF with an OR of 2.25 (95% CI 1.37, 3.7); Post datism had significantly higher odds for being a risk factor for MSAF with an OR (3.194) (CI 95% 1.003-10.165). MSAF was not found to be significantly associated with abnormal trace on CTG. Neonatal morbidity (MAS, birth asphyxia, sepsis, HIE) had statistically higher odds in cases 1.669 (0.884-3.150) as compared to controls.Conclusions: No particular cardio-tocograph pattern can be considered to have a poor prognostic value in the presence of thick MSAF and the decision to deliver and the mode of delivery should be based on the overall assessment and the stage and progress of labor. While management should be individualized, a higher Caesarean section rate in thick MSAF can be justified to ensure a better outcome for the neonate even in the presence of a normal CTG trace.

scholarly journals Study of length of umbilical cord and fetal outcome: a study of 1000 deliveries

2017 ◽  
Vol 6 (9) ◽  
pp. 3770
Author(s):  
Shiva Kumar H. C. ◽  
Chandrashekhar T. Tharihalli ◽  
Chandrashekhar K. ◽  
Suman F. Gaddi
Keyword(s):  
Heart Rate ◽  
Umbilical Cord ◽  
Apgar Score ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Birth Asphyxia ◽  
Fetal Outcome ◽  
The Body ◽  
Operative Interference ◽  
Cord Length

Background: Human embryo develops inside the body of the mother. One of the important part of the fetoplacental unit is the umbilical cord. The umbilical cord is the lifeline of the fetus. Objective of present study was to investigate the correlation of umbilical cord length with fetal parameters like APGAR score, sex, weight, and length, and its effect on labor.Methods: This prospective study conducted in the Department of OBG of VIMS, Bellary, from 1st February 2016 to 31st January 2017. The 1000 pregnant women of >37 weeks were studied following delivery for length of umbilical cord, any loop around neck, trunk, shoulder and number of loops of cord; knots of cord etc. Fetal parameters recorded were sex, weight, and length of the newborn and APGAR score at 1 and 5 min.Results: Cord length varied from 22 to 126 cm. The mean cord length was 66 cm (±10 cm). Maximum cases have cord length of 61and 70 cm. Lower 5th percentile and upper 5th percentile considered as short and long cord. Short-cord group was associated with significantly higher (p<0.05) incidence of LSCS cases. The incidence of all types of cord complications increases as the cord length increases (p<0.001). Nuchal cords had higher mean cord length and as the number of loops in a nuchal cord increases to two or more loops, the operative interference and fetal heart abnormalities increases. Fetal heart rate abnormalities and birth asphyxia increase with extremes of cord length (p<0.001).Conclusions: Short and long cords are associated with increased incidence of cord complications, operative interference, intrapartum complications, increased fetal heart rate abnormalities, and birth asphyxia. But cord length did not vary according to the weight, length, and sex of the baby.

scholarly journals TO STUDY THE ASSOCIATION OF PERINATAL OUTCOME WITH MECONIUM STAINED LIQUOR IN TERM PREGNANCY IN A BUSY PERIPHERAL TERTIARY CARE HOSPITAL

2021 ◽  
pp. 1-4
Author(s):  
Preeti Pushpam ◽  
Seema Seema ◽  
Debarshi Jana
Keyword(s):  
Heart Rate ◽  
Birth Weight ◽  
Caesarean Section ◽  
Amniotic Fluid ◽  
Apgar Score ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Control Group ◽  
Meconium Aspiration ◽  
Meconium Stained Amniotic Fluid

Passage of meconium still remains an enigma to the obstetrician and equally worries the paediatrician. The presence of meconium in amniotic fluid is still believed to be a serious sign of intra –uterine fetal compromise which is associated with an increase in perinatal morbidity. Clear amniotic fluid on the other hand is regarded as a good sign of clinical reassurance to both the obstetrician as well as the pediatrician. The exact etiology of meconium stained amniotic fluid is unclear. In our study the mean gestational age of the meconium stained liquor group was 39.6 (+ 1.4) weeks and of the clear liquor group was 38.8 (+ 1.3) weeks. In our study , 32% of the cases in the meconium stained group had gestational age between 40 – 42 weeks in comparison to only 13% patients in the control group. Our study concluded that meconium stained amniotic fluid was more prevalent in primigravidas (59%).No significant co-relation was found between age and meconium stained amniotic fluid. There is a greater incidence of meconium stained amniotic fluid in the unbooked population. As per our study, 35% of the patients in the meconium stained group were unbooked compared to 11% of the population in the control group. Overall, 77% of the population was booked and 33 % were unbooked. In our study , 47% of the patients had thin meconium , 20 % had moderate and 33% of the patients had thick meconium. As per present study, there was a greater incidence of fetal heart rate abnormalities in the form of abnormal CTG in meconium stained group in comparison to the clear group. In the group with meconium stained liquor, 30% of the patients had fetal heart rate abnormalities whereas only 12% of the patients in the clear liquor group had fetal heart rate abnormalities. Meconium stained liquor is associated with increased rate of operative deliveries as per our study. In our study , we found that 46% of the patient in the MSAF group underwent caesarean section whereas in the clear liquor group , 25% of the patients underwent caesarean section. In the MSAF group 49% patients had vaginal delivery and 5% had instrumental delivery. From the present study , we concluded that the percentage of babies with Apgar score <7 at 1 minute in the meconium stained group was more compared to the clear liquor group. In our study 27% of the babies in the MSAF group had low Apgar scores compared to only 11% of the babies in the clear liquor group.73% of the babies in the MSAF group had Apgar score >7. No significant co-relation was noted between Apgar score at 5 minutes and meconium staining of liquor. 9% of the babies in the meconium stained group had Apgar score <7 at 5 minutes compared to 6% of controls. Majority(46%) of the babies had birth weight between 2.5 – 3.0 kg whereas a significant percentage of babies had birth weight below 2.5 kg (21%). Meconium stained amniotic fluid is associated with a greater number of SNCU admissions. In our study, 20% of the babies in the meconium stained group were admitted to the nursery in comparison to only 9% nursery admissions in the clear liquor group. In this study it was seen that meconium aspiration syndrome was prevalent in the thickly stained group than in thinly stained group. 80% of the babies having meconium aspiration were in the thick meconium group. Early neonatal death did not seem to be significantly associated with meconium stained amniotic fluid , as per our study. 3 out of 100 babies born in the meconium stained group died whereas there was no death in the clear group.

scholarly journals Correlation of reduced amniotic fluid index with neonatal outcome

2017 ◽  
Vol 6 (6) ◽  
pp. 2401 ◽  
Author(s):  
Rachna Chaudhary ◽  
Vandana Dhama ◽  
Shakun Singh ◽  
Madhumita Singh
Keyword(s):  
Heart Rate ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Amniotic Fluid ◽  
Fetal Heart Rate ◽  
Neonatal Death ◽  
Neonatal Outcome ◽  
Fetal Heart ◽  
Birth Asphyxia ◽  
Apgar Scores

Background: Amniotic fluid assessment is an essential part of evaluation of fetus health in terms of fetal distress, meconium aspiration, IUGR, Non-reassuring fetal heart rate patterns, birth asphyxia, low birth weight, low Apgar-scores and NICU Admissions.Methods: This prospective observational study included 200 antenatal patients of term gestation of which 100 cases with AFI<8 and 100 controls with AFI ≥8 but ≤ 15 were included in study. Ultrasonography and NST were done and results of both groups compared for the presence of meconium passage, non-reactive NST, birth asphyxia, low Apgar-scores, low birth weight, NICU admissions and neonatal deaths.Results: There was increased incidence of non-reactive NST (40% vs 12%), meconium stained (33% vs 10%) in oligohydramnios group. In cases 49% of patients had vaginal delivery while in controls 78%. 51% underwent LSCS in cases while in controls 22%. Apgar score <7 was found in 7% vs 4%. Birth weight was <2.5 kg in 35% vs 13%. NICU admissions in study group was 15% vs 11%. The neonatal death was similar in both cases groups.Conclusions: Oligohydramnios affect the neonatal outcome in terms of meconium stained liquor, non-reassuring fetal heart rate, low birth weight, birth asphyxia, low Apgar-scores and NICU Admissions and neonatal death but the difference was not statistically significant. Early detection of oligohydramnios and its management may help in reduction of perinatal morbidity and decreased caesarean deliveries.

Discussion: ‘Abnormal fetal heart rate tracings in patients with thick meconium staining of the amniotic fluid’ by Xu et al

2009 ◽  
Vol 200 (3) ◽  
pp. e1-e4 ◽  
Author(s):  
Alison G. Cahill ◽  
Laura Parks ◽  
Lorie Harper ◽  
Erica Heitmann ◽  
Kathleen O'Neill
Keyword(s):  
Heart Rate ◽  
Amniotic Fluid ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Meconium Staining

Abnormal fetal heart rate tracings in patients with thick meconium staining of the amniotic fluid: Xu et al

2009 ◽  
Vol 200 (3) ◽  
pp. 342-343 ◽  
Author(s):  
Alison G. Cahill ◽  
Laura Parks ◽  
Lorie Harper ◽  
Erica Heitmann ◽  
Kathleen O'Neill
Keyword(s):  
Heart Rate ◽  
Amniotic Fluid ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Meconium Staining

A Clinical Study of Fetal Outcome in Cases of Nuchal Cord

1970 ◽  
Vol 7 (1) ◽  
pp. 25-27 ◽  
Author(s):  
AA Begum ◽  
H Sultana ◽  
R Hasan ◽  
M Ahmed
Keyword(s):  
Heart Rate ◽  
Caesarean Section ◽  
Apgar Score ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Fetal Outcome ◽  
Normal Vaginal Delivery ◽  
Close Monitoring ◽  
Fetal Heart Rate Monitoring ◽  
Nuchal Cord

Introduction: The umbilical cord around the neck of the fetus at the time of birth is nuchal cord. Objectives : To study the perinatal events and fetal outcome in cases with nuchal cord and formulate a plan for safe delivery. Methods: This cross sectional prospective study of 152 cases of nuchal cord (out of 1646 deliveries) was carried out in department of Obstetrics and Gynaecology of a Combined Military Hospital of Bangladesh during the period of two years. The nuchal cords were classified as tight coils or loose coils. Apgar score at 1 and 5 minutes after birth were recorded. Birth weight and sex of all babies were noted. Cord length was measured and considered as long (>70 cm) and short (<35 cm). Results: Out of 152 cases 128 (84.21%) had normal vaginal delivery, 3 (1.97%) cases had instrumental delivery, 21 (13.82%) cases underwent caesarean section and fetal distress was the main indication (16 out of 21). Only 22 (14.47%) of fetuses manifested fetal heart rate variation mostly variable deceleration (10 out of 22). Neonates born with tight nuchal cord had low Apgar score in one minute in comparison to loose (p<0.05), whereas significantly low Apgar score after 5 minutes was observed in babies born with multiple nuchal cord. Conclusion: The presence of a nuchal cord per se is not found to be an indication of operative delivery. However, such patients require close monitoring during labour, preferably by continuous electronic fetal heart rate monitoring as well as strict maintenance of partogram. Key words: Nuchal cord; normal delivery; caesarean section; fetal outcome DOI: http://dx.doi.org/10.3329/jafmc.v7i1.8622 JAFMC Bangladesh. Vol 7, No 1 (June) 2011; 25-27

scholarly journals Study of perinatal outcomes in normal and borderline oligamnios

2019 ◽  
Vol 9 (1) ◽  
pp. 279
Author(s):  
Divya R. Prasad ◽  
Neelima V. Nair
Keyword(s):  
Heart Rate ◽  
Caesarean Section ◽  
Amniotic Fluid ◽  
Fetal Heart Rate ◽  
Perinatal Outcome ◽  
Fetal Heart ◽  
Mode Of Delivery ◽  
Perinatal Outcomes ◽  
Amniotic Fluid Index ◽  
Meconium Staining

Background: Oligamnios is a common cause of perinatal mortality and morbidity, but the outcome of borderline oligamnios, defined as Amniotic Fluid Index (AFI) between 5 and 8, is less clear. This study aims to find out the effect of borderline oligamnios on perinatal outcomes in pregnancies beyond 37 weeks.Methods: An observational prospective study of 131 antenatal mothers with AFI between 5 and 8, after 37 weeks of gestation was conducted in Sree Gokulam Medical College and Research Foundation from October 2017 to September 2019. These observations were compared with that of 131 antenatal mothers with normal AFI beyond 37 weeks of gestation. The observations according to fetal heart rate abnormalities, meconium staining of amniotic fluid, mode of delivery, low birth weight babies, APGAR score, the need of neonatal intensive care unit (NICU) admissions due to neonatal complications were statistically analysed.Results: Both groups were comparable with respect to age, parity and gestational age. In those with borderline oligamnios, fetal heart rate abnormality was seen in 21% (28), meconium stained amniotic fluid in 18% (23), 70% (91) delivered vaginally and 30% (40) underwent caesarean section, 31% (41) babies weighed below 2.5 kg and 21% (27) neonates needed NICU admissions. In those with normal AFI, none showed fetal heart rate abnormality, 2% (3) showed meconium staining, 93% (122) delivered vaginally and 7% (9) underwent caesarean section, 11% (14) babies weighed below 2.5 kg and 3% (4) neonates needed NICU admissions.Conclusions: Borderline oligamnios is associated with poor perinatal outcome. AFI can be used as an adjunct to other fetal surveillance methods. It helps to identify those infants at risk of poor perinatal outcome.

FETOMATERNAL OUTCOME IN MECONIUM STAINED AMNIOTIC FLUID IN A TERTIARY RURAL HEALTH CARE CENTRE

2021 ◽  
pp. 31-33
Author(s):  
Yeshwanthini J ◽  
Mahendra G ◽  
Ravindra S Pukale
Keyword(s):  
Heart Rate ◽  
Fetal Heart Rate ◽  
Fetal Heart ◽  
Birth Asphyxia ◽  
Well Being ◽  
Fetal Outcome ◽  
Meconium Aspiration Syndrome ◽  
Medical Sciences ◽  
Health Care Centre ◽  
Fetal Heart Rate Monitoring

Background: The study was undertaken to determine the correlation of amniotic uid stained with meconium (MSAF) with maternal and fetal outcome. Methods: This prospective observational study was carried out in the Department of Obstetrics and gynecology, Sri Adichunchanagiri Institute of Medical Sciences, BG Nagara for over a period of 6 months between July 2020 and December 2020. A total of 168 pregnant women were included in the study. MSAF on spontaneous or articial rupture of membranes were monitored during labour with fetal heart rate abnormality, consistency of liquor, 1 minute and 5 minute Apgar score, LSCS, instrumental delivery, NICU admissions and neonatal complications as outcome variables. Results: Women were divided into two groups: 69 were cases with meconium stained amniotic uid (MSAF) and 99 were controls with clear amniotic uid. Among 69 cases with MSAF 17.4% were unbooked & 82.6% were booked (at least 3 visits in rst trimester), 79.7% were between 20-30 years of age group. Primigravida's constituted 55.1% in the study group. Approximately 34.8% had gestational ages of >39- 40 weeks. Caesarean section done in cases of MSAF accounted for 55.1% Normal deliveries were 36.2% in cases and 45.5% in controls. Conclusions: Presence of MSAF is worrisome for both the obstetrician and pediatricians view as it increases surgical intervention, birth asphyxia, MAS & NICU admissions. Continuos fetal heart rate monitoring during labour and reassurance of fetal well-being by acid-base assessment were most signicant factors in the reduction of meconium aspiration syndrome

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