scholarly journals An observational study of meconium aspiration syndrome and its immediate outcome with relation to thick and thin meconium stained amniotic fluid

2018 ◽  
Vol 5 (2) ◽  
pp. 552
Author(s):  
Sushant Kumar ◽  
Minni Rani Akhouri

Background: Meconium-stained amniotic fluid (MSAF) accounts for approximately 10-15% of live births and Meconium aspiration syndrome occurs in 5% among infants born through MSAF. The purpose of this study was to evaluate the outcome in neonates with meconium aspiration syndrome with regard to thin and thick meconium. Methods: A prospective cohort study of inborn neonates was done from April 2016 to August 2017 admitted in neonatal intensive care unit, Department of Paediatrics and Neonatology, RIMS, Ranchi after obtaining written informed consent from the parents or guardian and diagnosis of MAS was made depending on the clinical criteria and its clinical outcome was observed. MAS babies were studied on the basis of thin and thick meconium stained amniotic fluid.Results: The mean birth weight in thin meconium was 2760±394. The mean APGAR score in thin meconium at 1 minute (3.57±1.01) and 5 minutes (5.57±1.62) was significantly more than thick meconium. The mode of delivery in thin meconium was commonly by cesarean section (76.9%). There was need for resuscitation in 46.1% in thin meconium neonates which was significantly higher than neonates born with thick meconium 6.6% (P value 0.000). The most common complication in thin meconium was birth asphyxia (69.2%), followed by ARF and septicemia. Death was significantly higher in neonates born with thin meconium (69.2%)as compared to thick (20%) with P value of 0.000Conclusions: Amniotic fluid with thin meconium may cause more respiratory and other complications in neonates than amniotic fluid with thick meconium. Hence proper diagnosis and timely intervention can reduce the morbidity and mortality in neonates with meconium aspiration syndrome.

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):  
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.


Author(s):  
Kapil Singh Niranjan ◽  
Pesona Grace Lucksom

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.


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)


Author(s):  
Richa Rathoria ◽  
Ekansh Rathoria ◽  
Utkarsh Bansal ◽  
Madhulika Mishra ◽  
Ila Jalote ◽  
...  

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.


Author(s):  
Alfiati Nanda Widiyaningrum ◽  
◽  
Bhisma Murti ◽  
Eti Poncorini Pamungkasari ◽  
◽  
...  

ABSTRACT Background: Meconium aspiration syndrome refers to the aspiration of meconium and amniotic fluid by the fetus. It can occur when the fetus is still in the uterus, passing through the birth canal or when it takes its first breath after birth. Meconium aspiration is a serious condition with high morbidity and mortality. This study aimed to examine the effect of meconium stained amniotic fluid on the risk of infants asphyxia. Subjects and Method: Meta analysis and systematic review was conducted by collecting published articles from PubMed, Google Scholar, Clinical Key, Science Direct, and Springer Link databases. Keywords used risk factor, asphyxia, birth asphyxia, meconium stained amniotic, meconium stained liquor, and cross sectional. The inclusion criteria were full text, using English language, using cross-sectional study design, and reporting adjusted odds ratio. The study population was infants. Intervention was meconium stained amniotic liquid with comparison clean amniotic liquid. The study outcome was asphyxia. The collected articles were selected by PRISMA flow chart. The quantitative data were analyzed by fixed effect model using Revman 5.3. Results: 7 studies from Ethiopia reported that meconium stained amniotic fluid increased the risk of asphyxia in infants 5.83 (aOR= 5.83; CI 95%= 4.15 to 8.20; p <0.001). Conclusion: Meconium stained amniotic fluid increases the risk of asphyxia in infants. Keywords: meconium, amniotic fluid, asphyxia, infants Correspondence: Alfiati Nanda Widiyaningrum. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile:081327524537. DOI: https://doi.org/10.26911/the7thicph.03.130


2018 ◽  
Vol 5 (3) ◽  
pp. 726
Author(s):  
Ravi Garg ◽  
Rupesh Masand ◽  
Chaman Ram Verma ◽  
Girdhari Lal Sharma ◽  
Suman Ankit Yadav

Background: Meconium aspiration syndrome (MAS) is commonly encountered entity in neonates delivered in rural health centres.Methods: A prospective observational study was conducted in 50 consecutive cases of MAS who were admitted in Level III NICU of the Department of Pediatrics of a tertiary care teaching hospital located 50 kms from Jaipur city amidst rural surroundings from 1st January 2016 to 31st July 2017. Appropriate statistical analysis was carried out using Medcalc statistical software (version 16.4).Results: Out of 3585 deliveries, prevalence of MSAF and MAS was 14% and 8.5% respectively. The M:F ratio of study subjects was 1.2:1.The maternal risk factors significantly associated with MAS were maternal anemia (p value-<0.001), maternal age >30 (p value-0.025) and unbooked pregnancies (p value-0.032). The mean birth weight was 2734±499gms. Majority of cases of MAS were seen in babies with birth weight between 2.5-3.5 kg (n=30, 60%).The mean gestational age was 38.6±2.4 weeks. 30 (60%) babies were delivered after completing 37-<40 weeks of gestation and 9 (18%) babies were of 40-<42 weeks of gestation. The common complications observed were exaggerated physiological hyperbilirubinemia (75%), birth asphyxia (50%) and septicaemia (27.08%). The commonest cause of mortality was birth asphyxia (57.14%) and pneumonia (42.8%).Conclusions: MAS is a cause of concern for the attending obstetrician and pediatrician as it is associated with life threatening complications and mortality. Efforts need to be invested in promotion of institutional antenatal care and institutional deliveries so that maternal risk factors can be identified and managed effectively, especially in rural areas.


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.


Author(s):  
Kalpesh Patel ◽  
Radha Rastogi

Background: Meconium is sterile, thick, black-green, odourless material, formed by accumulation of debris in the fetal intestine. This meconium, when leaks out intra-natally, due to hypoxia, can change the whole scenario, increasing intra-natal foetal risk, morbidity, and possibly causing mortality, depending upon the operative factors. Aims and objectives were to know the perinatal outcome in patients with meconium stained amniotic fluid. To study the complications of meconium stained amniotic fluid in the neonates.Methods: Reverse-transcription polymerase chain reaction (RTPCR) negative women, gestational age >37 weeks with cephalic presentation and singleton pregnancy with meconium stained liquor (grade I, II, and III) after spontaneous or artificial rupture of membranes during labour. Delivery was expedited, when fetal heart rate abnormalities were detected, by safest mode of delivery. The Apgar score of neonates, neonatal intensive care unit (NICU) admission, number of days of hospitalization and birth asphyxia were recorded.Results: A Total 11 patients with pre-eclampsia which presented with meconium stained liquor (MSL). 6 patients with prolonged labour presented with MSL. 8 had thin, 15 had thick MSL and 3 patients of clear liquor. 2 children developed persistent pulmonary hypertension of the newborn (PPHN) in case of MSL group. 25 children required oxygen support and antibiotics after delivery. Mean hospital stay was 2.81 days in MSL and 1.33 days in clear liquor group.Conclusions: Chronic hypoxia is more damaging and dangerous than acute hypoxia, due to longer time it has continued the damage. This can be very effectively achieved by improving the Antenatal care, and intra natal vigilance. Proper monitoring of patients in intrapartum period of following parameters like fetal heart sound, uterine contractions, fetal movements.


Author(s):  
Aruna Biradar ◽  
Shreedevi Kori ◽  
Neelamma Patil ◽  
S. R. Mudanur

Background: The aim of this study is to know the association between the meconium stained amniotic fluid and its association with the perinatal outcome.Methods: All the patients coming to present hospital for delivery with meconium stained liquor during the study period were included in the study.Results: 163 cases with meconium stained liquor (MSAF) were included in the study, 124(76.1%) and 39(23.9%) had thin and thick MSAF respectively. Among these cases, thick MSAF was more associated with high fetal heart rate (FHR) variability (p value- 0.030), associated with increased rate of operative interference (64.1%; p value- 0.001), abnormal Apgar score (p value-0.003 at 1min and 0.001 at 5min) and increased neonatal intensive care unit (NICU) admission (33.3%; p value - <0.001).Conclusions: Present study showed that thick meconium is associated with more complications like increased operative interference, birth asphyxia, meconium aspiration syndrome, low Apgar score, prolonged NICU stay and overall increased perinatal mortality compared to thin meconium stained liquor. As the gestational age increased the incidence of meconium increased and a greater number of thick meconium had abnormal CTG.


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