scholarly journals Neonatal outcome in meconium stained amniotic fluid: a hospital based study

2017 ◽  
Vol 4 (2) ◽  
pp. 356 ◽  
Author(s):  
Gurmeet Singh ◽  
Onkar Singh ◽  
Karuna Thapar

Background: Amniotic fluid surrounds the baby in utero and provides a protective and low resistance environment and acts as a cushion for the baby. It is secreted by amniotic membranes, foetal skin and fetal urine. The objectives of this study was to identify the incidence of meconium stained amniotic fluid, perinatal outcome and the risks during pregnancy leading to in utero passage of meconium.Methods: A prospective study conducted in Sri Guru Ram Das University, Amritsar, between 1st December 2014 to 1st June 2016. All live births with meconim stained amniotic fluid without congenital malformation, twin or multiple organ dysfunction were taken as subjects of this study. Maternal obstetric history and risk factors were asked and foetal parameters including gestational age, fetal presentation, mode of delivery, birth weight, sex, Apgar score, age at onset of respiratory distress, treatment and outcome were observed.Results: Out of 1121 admissions in NICU, 12% of inborn and 9.6% of outborn were with MSAF, out of which 34% developed MAS. Majority of neonates were observed to be males (73.6%), term neonates (67.2%), weight 2.5-3.5 kg (76.9%) with mean weight being 2.701 kg±0.558 kg and 16% mortality including 9 inborn and 11 outborn neonates. Mean age at onset of respiratory distress was 18.43 minutes±11.52 minutes. Neonatal outcome was significantly related to weight, APGAR score at 5 mins, and development of complications like MAS, hypoxic ischemic encephalopathy, necrotizing enterocolitis, acute renal failure and severe thrombocytopenia. Culture proven septicaemia was seen in 21.6% cases. Mean duration of stay in NICU was 6.48 days±0.54 days.Conclusions: MSAF has significant effect on perinatal outcome and close observation is required to prevent and treat complications thus reducing mortality.

2015 ◽  
Vol 4 (2) ◽  
pp. 44-49 ◽  
Author(s):  
Nasrin Begum ◽  
Sharmeen Mahmood ◽  
Salma Akhter Munmun ◽  
MS Haque ◽  
KN Nahar ◽  
...  

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)


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):  
Vandana Mohapatra ◽  
Sujata Misra ◽  
Tapas Ranjan Behera

Background: The presence of meconium-stained amniotic fluid is a sign of fetal compromise and is associated with increased perinatal morbidity. The objective of this study was to determine the perinatal outcome in pregnant women at term with meconium-stained amniotic fluid (MSAF) and compare it with the outcome associated with clear liquor. Methods: A prospective observational, study was conducted in the department of obstetrics and gynecology, VIMSAR, Burla from January, 2013 to June, 2013. Pregnant women with singleton pregnancy, cephalic presentation at term were included in the study. Total 135 cases of MSAF (study group) were compared with 165 randomly selected controls with clear liquor. Outcome measures were fetal heart rate (FHR) abnormality, mode of delivery, Apgar score, neonatal intensive care unit (NICU) admission, diagnosis of meconium aspiration syndrome (MAS), birth asphyxia and neonatal death. Statistical analysis was done by using the mean and Chi-square test with or without Yates’ correction.  Results: The mean gestational age for meconium staining in the present study was 40.31±0.48 weeks. Caesarean section was the most common mode of delivery in MSAF group whereas vaginal delivery was most common in control group. Significantly higher number of babies in the study group required NICU admissions. The incidence of MAS and birth asphyxia too was statistically higher among babies born to study group as compared to control group.Conclusions: MSAF has significant adverse effect on the perinatal outcome, as it increases the caesarean section rates, NICU admissions, MAS and birth asphyxia.


2018 ◽  
Vol 5 (5) ◽  
pp. 1824
Author(s):  
Raju V. ◽  
Dhivya Narayani M. ◽  
Vindyarani W. K.

Background: The detection of meconium-stained amniotic fluid during labour often causes anxiety in the delivery room because of its association with increased perinatal mortality and morbidity. The aim of the study is to determine whether meconium staining of amniotic fluid had an influence on the neonatal outcome and the factors responsible for meconium-stained amniotic fluid.Methods: This case-control study was done between March 2015 to October 2017 in the Department of Paediatrics, Sri Muthukumaran Medical College, and RI. 217 newborns who had meconium staining of the amniotic fluid were taken into the study. For each case, two controls were taken. Mode of delivery of baby noted with the grading of meconium either thin or thick meconium. Type of resuscitation done for these babies was noted. Those newborns who were admitted in the newborn unit were followed up till discharge and type of management of these babies were monitored. The outcome of seizures, air leak, MAS etc., were looked for. For each MSAF baby, two newborns without MSAF were recruited and looked for maternal and fetal risk factors.Results: Incidence of MSAF is 16.9%. Among 217 cases of MSAF, thin meconium constituted 141 cases (64.97%) and thick meconium 76 cases (35.02%). The incidence of thin meconium is more when compared to thick meconium. Of the 217 cases of meconium-stained liquor, 170 (78.7%) cases are vigorous babies and 47 (21.6%) are non-vigorous. Out of 47 babies who were non-vigorous, most of them (70.2%) had thick meconium stained liquor. Most of them, 172 cases (79.2%) required only routine resuscitation, whereas BMV with tracheal toileting required in 18 cases (78.3%) of thick MSAF when compared to 5 cases (21.7%) of thin MSAF.Conclusions: MSAF is associated with morbidity and mortality when associated with factors like maternal PIH, anemia, oligohydramnios, IUGR babies and CTG showing FHR variability. The majority of which are thick meconium suggesting that consistency of meconium had a direct bearing on the neonatal outcome. 


Author(s):  
Meera Mohan ◽  
Deepak A. V.

Background: Meconium staining of amniotic fluid has long been regarded as a sign of fetal distress and fetal asphyxia. Although exact cause is unknown, meconium is thought to be passed from fetal gastro-intestinal tract as a response to hypoxia, mesenteric vasoconstriction induced gut hyper peristalsis, vagal stimulation and normal physiologic function of a mature fetus. Overall frequency has ranged from 5 to 24.6%. Present study is undertaken to detect incidence, mode of delivery, fetal heart rate variability and neonatal outcome in neonates born through MSAF. The objective of the study was to maternal risk factors, mode of delivery and perinatal outcome in labors complicated with meconium stained amniotic fluid.Methods: This is a cross sectional study done at Government Medical College, Thrissur on term, singleton pregnancies complicated with meconium stained amniotic fluid satisfying the inclusion criteria. Patients detailed history, gestational age, per abdominal examination, per speculum and per vaginal examination, admission tests including intrapartum cardiotocography (CTG) was recorded in a predesigned proforma.Results: The age of the patients varied between above 19 and 30 years. Majority of the study population were 69.3% Primi gravidas. Out of 130 cases, 56.2% were grade 2 meconium stained liquor, 30.7% were grade 3 meconium stained and 13.1% were grade 1 meconium stained. Association between neonatal complications in relation to grades of meconium was found to be statistically significant (p = 0.001). NICU admission was 24.7% in grade 2 meconium group. Hypoxic Ischemic encephalopathy was high in grade 3 meconium group, 45%. Majority of babies born through grade 1 meconium were asymptomatic and 10% of babies in grade 3 meconium groups were asymptomatic. Meconium aspiration syndrome, Respiratory distress were more in babies born through deliveries complicated with grade 3 meconium.Conclusions: The study indicated meconium stained amniotic fluid during labour increases the prevalence of abnormal intrapartum CTG, Caesarean section, lower Apgar score, increased duration of NICU and hospital stay, poor perinatal outcome and non-significant difference in incidence of lower birth weight in babies.


2018 ◽  
Vol 5 (2) ◽  
pp. 569
Author(s):  
Girish N. ◽  
Shravani M. R. ◽  
Thrashree C. D. ◽  
Sunil B.

Background: Meconium Aspiraion Syndrome (MAS) is an important cause of morbidity and mortality among newborns in the developing world. Meconium stained amniotic fluid (MSAF) occurs in approximately 13% of all live births.Methods: This was a prospective observational study to assess the risk factors related with MSAF deliveries and MAS. All the details regarding mode of delivery, APGAR score (AS), birth weight, fetal distress, maternal age, any maternal illness, gestational age, clinical course, outcome was recorded and evaluated.Results: In the present study total of 100 babies born through MSAF were included of which the incidence of respiratory distress was noted in 62% (62 babies).Conclusions: Appropriate monitoring of respiratory distress at birth and assessing the high-risk cases will surely help in reducing the morbidity and mortality in vigorous babies born through MSAF.


1995 ◽  
Vol 62 (1) ◽  
pp. 63-67 ◽  
Author(s):  
A. Sasikala ◽  
S. Raghavan ◽  
N. Mishra ◽  
S. Khatoon ◽  
A. Bupathy ◽  
...  

2015 ◽  
Vol 10 (1) ◽  
pp. 89-93
Author(s):  
R Joshi ◽  
G Baral

Aims: The purpose of this study was to determine the perinatal outcome of the second twin compared to the first one. Methods: This is a hospital based comparative study of 60 pregnant women with twin pregnancy at Paropakar Maternity and Women’s Hospital, Kathmandu from 14 January 2013 to13 April 2013. Apgar score and admission to neonatal intensive care unit of the first and the second twins were studied in relation to the gestational age, chorionicity, mode of delivery, inter-delivery interval and birth weight. Mc Nemars test was used with 0.05 as the level of significance. Results: Among 60 sets of twins, Apgar score of the second twin was found to be lower than the first one (p=0.02) in general and in preterm gestation (p=0.049), dichorionic diamniotic chorionicity (p=0.012), vaginal delivery (p<0.001), inter-delivery interval of <30 minutes (p=0.007) and birth weight discordance of <30 % (p=0.014). Admission to neonatal intensive care unit was not significant (p=0.5). Conclusions: Second twin had low Apgar score and the neonatal admission rate was similar for both twins. 


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