scholarly journals A study of maternal and fetal outcome in meconium-stained amniotic fluid-a prospective hospital-based study

Author(s):  
Aparna U. Dandale ◽  
Amarjeet Kaur Bava ◽  
Nikhil R. Shinde

Background: Meconium is a collection of secretions and desquamated cells from the digestive tract, and waste products from ingested amniotic fluid. It is a viscous, dark-green substance composed of intestinal epithelial cells, lanugo, mucus, and intestinal secretions. Intra uterine passage of meconium occurs in case of fetal distress; Important causes of in utero passage of meconium are oligohydramnios, placental insufficiency, preeclampsia.Methods: The present prospective observational study is conducted at department of obstetrics and gynecology of tertiary care centre, Lokmanya Tilak municipal medical college and hospital, Mumbai. All antenatal women attending hospital in active phase of labour who fulfilled the inclusion criteria of single term pregnancy in cephalic presentation were included. A predesigned pretested interview schedule questionnaire was prepared in accordance with study objectives and was conducted in the language which they best understood. Permission was obtained from the institutional ethics committee. Maternal outcome: Increased incidence of cesarean and instrumental deliveries, wound infection, post-partum hemorrhage. Perinatal outcome: Birth asphyxia, meconium aspiration syndrome (MAS), respiratory distress syndrome (RSD), septicemia.Results: Maximum women 71% were having gestational age of 37-40 weeks. most common maternal high-risk factors were post-dated pregnancy (29%) followed by oligohydramnios (19%). Deliveries by caesarean section were more (71.4%), most common indication being fetal distress (44.7%). Perinatal complications were birth asphyxia, MAS, RDS, low Apgar score.Conclusions: Early identification of meconium-stained amniotic fluid (MSAF) in labouring women during intra-partum monitoring and availability of operation theatre for immediate intervention is required to reduce the perinatal morbidity and mortality.

Author(s):  
Defairlin Ranee ◽  
Deepa S. Phirke

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.


2020 ◽  
pp. 71-73
Author(s):  
Kajal Kunwar ◽  
Shanti HK Singh

Aims and objectives: To identify various factors for meconium stained amniotic fluid (MSAF) and comparison of pregnancy outcome in meconium stained vs. clear amniotic fluid. Material and Methods: The study was conducted at the Department of Obstetrics and Gynaecology of a teaching tertiary care hospital. Out of 850 deliveries, 100 cases of MSAF were studied for 17 months. Detection of MSAF during delivery and follow-up of mother and baby during hospital stay was done. Results: Overall incidence of meconium staining of AF during labor was in the present study 11.6%. The incidence of meconium staining was much greater in postdated pregnancy and oxytocin-induced labor. Birth asphyxia was more common when the AF was meconium stained and severity was directly proportional to the degree of thickness of MSAF. Abnormal heart rate was much more frequent in the study group and when thick meconium was associated with bradycardia fetal outcome was worst. Conclusion: Prevention of fetal distress and maternal hypertension can reduce MSAF to ultimately minimize cesarean /instrumental delivery and adverse fetal outcome. This study confirmed that our clinical impression– “meconium staining of amniotic fluid adversely influence the fetal outcome”


2021 ◽  
Vol 8 (2) ◽  
pp. 53-57
Author(s):  
Dr. Asmita Misal ◽  
Dr. Urmila Gavali ◽  
Dr. Gautam S. Aher

Background: Pregnancy beyond term is associated with adverse maternal and perinatal outcome. The aim of the study the maternal and perinatal outcome in pregnancies at and beyond 41 week of gestation. Methods: This is a prospective study of 140 patients with pregnancy beyond 41 weeks fulfilling the eligibility criteria and admitted and delivered in department of obstetrics and gynaecology at a tertiary care hospital. We examined its association with following outcomes: age, parity, genetic factors, bishop’s score at admission, mode of delivery, induction rate, meconium stained amniotic fluid, oligohydramnios, Perinatal and neonatal morbidity, Perineal tear, postpartum haemorrhage, maternal morbidity and mortality etc. Results: Out of 140 patients, majority in the age group of 21-25 years, 68 (48.6%) patients were primigravida while 72 (51.4%) patients were multigravida. Maximum patients 65% were not in labour whereas 35% were in labour. In 51 (36.4%) patients mode of delivery was caesarean section, in which most common indication being foetal distress in 25.5% followed by meconium stained amniotic fluid in 17.6%. In present study perinatal morbidity like stillbirth, RDS were 2.86% & 25.8% respectively. Maternal morbidity like PPH, tear and wound infection were 4.31%, 6.4%, 0.7%respectively. Conclusions: With Regular antenatal check-up, incidence of post term pregnancy can be decreased and Labour induction should be considered at 41weeks to prevent lot of maternal and perinatal complications.


Author(s):  
Vijay Zutshi ◽  
Neha Mohit Bhagwati ◽  
Alka .

Background: SARS-CoV-2 has caused significant morbidity and mortality worldwide. Analysis of the clinical profile of COVID-19 positive pregnant women is important to understand the pathophysiology, transmission and outcome of the disease in Indian population.Methods: It is a retrospective observational study of first fifty pregnant patients tested positive for COVID-19 by qRT PCR admitted for delivery in our hospital.Results: In this audit, first fifty COVID-19 pregnant women were studied and the mean age of the patients in this study was 26 years. 98% of these women were admitted for obstetric indications. Seventy two percent of these women were admitted with spontaneous onset of labour. Based on disease severity, 49 (98%) were either asymptomatic or exhibited mild disease and only 1 (2%) had severe disease who succumbed to her illness. Forty six percent patients delivered vaginally and 54% required cesarean delivery. The most common indication for LSCS was fetal distress (43%). Eighteen percent had preterm delivery. Among the newborn babies, one died due to severe birth asphyxia. Sixteen percent babies required NICU stay. Five babies tested positive for COVID-19 of which one baby was positive on day one of life.Conclusions: As per our results, majority of the COVID-19 positive pregnant women had mild disease. There has been increase in cesarean section rate as compared to the previous hospital figures. Only one baby tested positive within 24 hours of delivery so the possibility vertical transmission can not be commented upon as of today.


Author(s):  
Ritika Narayan ◽  
Sheela S. R.

Background: Post-dated pregnancy is when the gestation is more than 40 weeks or 280 days. They last longer than the estimated date of delivery. Postdated pregnancies are associated with increased perinatal and maternal complications. These risks are greater than it was originally thought. Risks have been underestimated in the past leading to increasing number of complicated postdated pregnancies which appears to be otherwise low risk. The maternal risks are very often underappreciated resulting in increased maternal morbidity.Methods: This cross sectional observational study was done to evaluate maternal and fetal complications associated with Postdated pregnancies was carried out in the department of obstetrics and gynecology in a tertiary care centre, Sir Devraj Urs Medical College and RL Jalappa Hospital, Kolar between July 2018 and July 2019, fulfilling all the inclusion and exclusion criteria.Results: 50 out of 100 patients had full term normal deliveries where as 45% patients required cesarean section. Most common indication for cesarean section was meconium stained liquor with fetal distress (25%). 42% of the babies born needed NICU admission. Most common maternal complication seen was Postpartum Hemorrhage.Conclusions: The present study we conclude that postdated pregnancy was associated with significant risk of perinatal complications such as fetal distress, meconium aspiration syndrome and IUGR. There was increased risk of obstetric complications as well like atonic PPH, oligohydramnios, obstructed labor.


Author(s):  
Swati Kagne ◽  
Sambhaji Chate

Background: Disorders of amniotic volume is one of the commonest obstetric problem. Amniotic fluid acts as cushion to the foetus allowing musculoskeletal development and also helps in the differentiation of lungs and gastrointestinal tract. Decreased amniotic fluid, known as oligohydramnios, is known to be associated with adverse perinatal outcome. The objective is to study the maternal and perinatal complications of oligohydramnios in term pregnancy.Methods: The present study was carried out in the Department of Obstetrics at rural tertiary care hospital in Maharashtra from February 2018 through October 2018. women with Oligohyamnios were studied for obstetrical and neonatal complications.Results: The incidence of oligohyamnios was 7.6% in present study. The mean age of the study population was 22.6±3.6 years. Induction of labour was required in 44 (61.11%) patients out of which 23 patients underwent emergency LSCS. Low birth weight (birth weight<2.5kg) was found in 14 (19.44%) babies with 11 babies having intrauterine growth restriction. 5-minute APGAR (appearance, pulse, grimace, activity, respiration) score was <7 in 13.88% babies. 16 babied needed NICU admission out of which 1 neonate died.Conclusions: Detection of oligohydramnios increases obstetrical interventions in term pregnancy.


2019 ◽  
Vol 6 (2) ◽  
pp. 491 ◽  
Author(s):  
Shilpasri Y. M. ◽  
Madhurya B.

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.


Author(s):  
Nitin Gyaras Puria ◽  
Krishna Pada Dutta

The presence of meconium stained amniotic fluid (MSAF) is a sign of fetal compromise. It is associated with significant neonatal morbidity and mortality. MSAF is frequently associated with high cesarean rate, prolonged labour,low APGAR scores, increased rate of birth asphyxia; increased NICU admission, meconium aspiration syndrome and neonatal death. The aim of this prospective study is to correlate the effect of meconium stained amniotic fluid on neonatal outcome. Keywords: Meconium stained amniotic fluid, Neonatal morbidity and mortality, NICU.


Author(s):  
Joshi D. Suyajna ◽  
Jayasakthi G. ◽  
Rajeswari Rai ◽  
Ruksar Banu

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.


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