scholarly journals Outcome of neonates born through Meconium stained amniotic fluid in tertiary health care centre

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.

2012 ◽  
Vol 10 (3) ◽  
pp. 198-202
Author(s):  
S Kumar ◽  
SN Gupta ◽  
IP Mahato ◽  
R Giri ◽  
A Yadav ◽  
...  

Introduction: Passage of meconium in utero is a dangerous sign for fetal outcome which influence the decision to deliver as well as the mode of delivery. Methods: This descriptive case control study was carried out in the department of Obstetrics and Gynaecology, Koshi Zonal Hospital from March 2006 to July 2006. A total of 50 women with meconium stained amniotic fluid( MSAF) were studied to identify maternal and fetal outcome and was compared with women with clear amniotic fluid. Results: Normal delivery was significantly higher (58%) in clear liquor group as compared to MSAF group (22%). Cesarean section was more common in MSAF group (66%) where as it was (38%) in the clear liquor group (p=0.005). Low Apgar scores of < 5 at one minute was seen in 48% of MSAF and 6% of clear liquor born babies (p<0.2). But at 5 minutes low Apgar score persisted in same 48% of MSAF babies whereas it was seen in 12% of clear liquor group (p<0.000). Among the babies born with MSAF 34% were referred to higher center compared to 6% in clear liquor babies (p=0.000). Four babies with thick MSAF and one baby with clear liquor had neonatal death (p=0.005). Conclusion: Mode of delivery and fetal outcome were adversely affected by the presence of thick meconium stained liquor as compared to clear liquor. Additional monitoring facilities e.g. cardiotocography (CTG) if available would reduce fetal distress and allow timely intervention in such cases. DOI: http://dx.doi.org/10.3126/hren.v10i3.7135 Health Renaissance; September-December 2012; Vol 10 (No.3);198-202


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.


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):  
Bhagyashri Gavhane ◽  
Sarika Thakare ◽  
Sachin Wankhede

Background: This study was carried out to determine the effect of meconium stained amniotic fluid on mode of delivery and correlation of thick and thin meconium with foetal outcome.Methods: This prospective observational study was carried out in the Department of obstetrics and gynecology, IGGMC Nagpur from September 2015 to August 2017. All pregnant women in labor with cephalic presentation with singleton pregnancy with meconium stained liquor irrespective of age, parity and stage of labor were enrolled in this study. 200 consecutive study subjects who fulfilled inclusion criteria were included in the study.Results: Out of 200 cases of MSAF, thick meconium was seen in 53.5% cases and thin meconium constituted 46.5% of the cases. The mean gestational age in present study was 39.31 ± 0.89 weeks. Overall incidence of LSCS in meconium stained amniotic fluid is 65.5%. The thick Meconium stained grades had significantly higher NICU admissions when compared to the thin meconium grades (p<0.05). In present study, the total perinatal mortality was 4%.Conclusions: MSAF were associated with higher rate of caesarean delivery. It causes birth asphyxia, MAS, increases NICU admissions and perinatal mortality.


PEDIATRICS ◽  
1966 ◽  
Vol 38 (5) ◽  
pp. 858-864
Author(s):  
Arthur J. Moss ◽  
Ovidio Rettori ◽  
Norman S. Simmons

The viscosity of amniotic fluid was measured in 52 ewes and the results correlated with the postnatal course of the lambs delivered by cesarean section. Viscosity was not related to length of gestation or to the immediate prepartum condition of the ewe, but a definite relationship was found between amniotic fluid viscosity (AFV) and the postnatal course of the fetus. Of 22 lambs considered viable, 9 failed to survive. In 10 of the 13 survivors, AFV was less than 1.6; whereas in the nonsurvivors, AFV varied between 1.6 and 4.4. All of the nonsurvivors experienced respiratory difficulty associated with copious amounts of extremely viscous secretions in the mouth and oropharynx. The substance responsible for the high AFV was a mucoprotein and was detectable in all samples with a viscosity of 1.24 or more but in none with a viscosity below 1.24. The data suggest the possibility that fetal distress may induce qualitative or quantitative alterations of fetal mucous secretions in utero which subsequently could impede lung expansion at birth.


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.


2021 ◽  
Vol 8 (3) ◽  
pp. 467
Author(s):  
Keziah Joseph ◽  
Bhargavi B. ◽  
C. S. Jain ◽  
Dasaradha Rami Reddy

Background: Transient tachypnea of the new born is a benign condition. The aim of the study is to find any correlation between the mode of delivery and occurrence of transient tachypnea of newborn.Methods: Study is proposed to assess the risk factor like caesarean section and its relationship with occurrence of TTN in term neonates and the clinical course of TTN cases admitted in Neonatal intensive care unit (NICU), Department of Pediatrics, Kamineni Institute of Medical Sciences, Narketpally, Nalgonda, Telangana.Results: During the study period, total number of deliveries in our hospital was 4576. Of 356 term neonates with respiratory distress admitted in NICU, the most common cause was found to be early onset sepsis i.e 168 of 356 cases accounting for 47.19%, followed by transient tachypnea of newborn i.e., 68 of 356 cases accounting for 19.10%.Conclusions: The mode of delivery i.e caesarean section has a significant impact on transient tachypnea of newborn (TTN) with a relative risk of 3.78 compared to normal vaginal delivery. The majority of cases had mild respiratory distress and were relieved of symptoms within 3 days of hospital stay.


2021 ◽  
Vol 8 (4) ◽  
pp. 642
Author(s):  
Venkatesh Dhannaram ◽  
Sumathi Kotapuri ◽  
Sudharshanraj Chitgupikar

Background: When the fetus is in a state of stress meconium is passed presence of meconium in amniotic fluid is potentially a serious Sign of fatal compromise, frequency of meconium strained amniotic fluid ranges from 5-22%. MSAF results in higher rate of cesarean delivery, NICU admission rate, respiratory distress, PPHN and neonatal death. The primary objectives of the study were to estimate the incidence of Meconium aspiration syndrome & Respiratory distress among babies born through meconium-stained amniotic fluid (MSAF) along with studying the outcomes at the end of 7 days.Methods: This was a prospective study undertaken in mediciti institute of medical sciences, Ghanpur Medchal Mandal from Jan 2018 to June 2019. Data was collected in a predetermined proforma after institutional ethical committee clearance and appropriate informed consent.Results: During this period 1972 neonates were delivered of which 216 babies were born through MSAF. 18 were excluded for non-cephalic presentation, multiple gestation or congenital anomalies.198 babies were included in the study (96 male and 102 female). 18 neonates (10.2%) needed resuscitation at birth. 85 (42.9%) had thick MSAF. 43 of them developed respiratory distress (21.7%). 10 babies were ventilated. Seizures, hyperbilirubinemia, thrombocytopenia were more common among babies with thick MSAF. Mortality was 1%.Conclusions: Thick meconium-stained amniotic fluid was associated with low Apgar score, higher rate of emergency cesarean section and meconium aspiration syndrome. Primigravida mothers, maternal hypothyroidism and oligohydramnios were important risk factors associated with MAS.


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.


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