scholarly journals Immediate clinical outcome of newborns with meconium stained amniotic fluid

2018 ◽  
Vol 5 (5) ◽  
pp. 1824
Author(s):  
Raju V. ◽  
Dhivya Narayani M. ◽  
Vindyarani W. K.
Keyword(s):  
Amniotic Fluid ◽  
Case Control Study ◽  
Neonatal Outcome ◽  
Mode Of Delivery ◽  
Air Leak ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Meconium Staining ◽  
Meconium Stained Amniotic Fluid ◽  
Control Study

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. 

scholarly journals Incidence of Chorioamnionitis in Patients With Meconium-stained Amniotic Fluid

1995 ◽  
Vol 2 (5) ◽  
pp. 210-212 ◽  
Author(s):  
Shelley Chapman ◽  
Patrick Duff
Keyword(s):  
Amniotic Fluid ◽  
Mode Of Delivery ◽  
Case Control ◽  
Host Immune System ◽  
Retrospective Case ◽  
Before And After ◽  
Accelerated Growth ◽  
Meconium Staining ◽  
Meconium Stained Amniotic Fluid ◽  
Growth Of Bacteria

Objective: The goal of this study was to determine if meconium staining of the amniotic fluid (MSAF) is a marker for chorioamnionitis.Methods: In a retrospective, case-control investigation, we studied 100 patients with MSAF. Each patient was matched with a control who delivered during the same period but did not have MSAF. Subjects and controls were matched for age, parity, gestational age, mode of delivery, duration of rupture of membranes (ROM), length of internal monitoring, and number of examinations before and after ROM. The incidence of chorioamnionitis in controls and study patients was compared. The diagnosis of chorioamnionitis was based on clinical examination.Results: Thirteen of the 200 patients [6.5%, 95% confidence interval (CI), 2.5–10.5%] developed chorioamnionitis. Of the 100 women with MSAF, 10 (10%, 95% CI, 4–16) were infected compared with only 3 controls (3%, 95% CI, 0–6, P = 0.04). The odds ratio (OR) for this comparison was 3.3, and the 95% CI was 1.02–10.63.Conclusions: MSAF is associated with an increased frequency of chorioamnionitis. Several factors could explain this association. Infection may cause fetal stress, leading to the release of meconium. MSAF may enhance the growth of bacteria by providing a rich medium of essential nutrients or growth stimulants. MSAF also may impair the host immune system so that chemotaxis or phagocytosis is diminished, thus allowing accelerated growth of microorganisms.

scholarly journals Meconium stained liquor in labour and mode of delivery: a time for reappraisal

2020 ◽  
Vol 9 (10) ◽  
pp. 4016
Author(s):  
Sharda Patra ◽  
Shruthi S. S. ◽  
Manju Puri ◽  
Sushma Nangia ◽  
S. S. Trivedi
Keyword(s):  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Fetal Heart ◽  
Mode Of Delivery ◽  
New Delhi ◽  
Medical College ◽  
Time Period ◽  
Meconium Staining ◽  
Latent Phase Of Labour ◽  
Latent Phase

Background: The objective of this study was to determine the significance of meconium staining of the amniotic fluid and find out an appropriate mode of delivery in women with MSL.Methods: A retrospective study was carried out in Lady Hardinge Medical College and Smt Sucheta Kriplani Hospital, a tertiary government hospital, New Delhi over a time period of 1 year between 2009 to 2010 on 1425 consecutive women of which 142 women were diagnosed as having meconium staining of the amniotic fluid during labour.  All cases were critically analysed and maternal and fetal outcomes were studied in these women.Results: The incidence of MSL was 10% (142/1425), 45% had thin MSL and 55% had thick MSL. In women with thick MSL, 85% had early thick MSL and 15% had late thick MSL. In women who had early thick MSL (n=66), 55 (83.3%) delivered by LSCS and 11 (16.7%) delivered vaginally. On correlating the perinatal outcome with mode of delivery irrespective of fetal heart rate abnormality in early thick MSL, it was seen that the perinatal outcome was significantly affected by mode of delivery. The rates of respiratory distress and MAS was significantly higher in babies who delivered vaginally compared to those by LSCS (18% & 100% vs 9% & 40%, p=0.012, RR- 5.2 [95% CI: 1.8-3.42]. There were no perinatal mortality in early thick MSL.Conclusions: In distinguishing between thick and thin meconium, it was noted that finding of thick meconium in the latent phase of labour (i.e. early thick MSL) is ominous and demands an urgent caesarean delivery. 

scholarly journals Risk Factors of Meconium-Stained Amniotic Fluid in Term Pregnancy - A Case Control Study

2021 ◽  
Vol 8 (13) ◽  
pp. 806-810
Author(s):  
Asha P.S ◽  
Sujatha T.L.
Keyword(s):  
Risk Factors ◽  
Caesarean Section ◽  
Amniotic Fluid ◽  
Case Control Study ◽  
Significant Risk ◽  
Case Control ◽  
Inclusion Criteria ◽  
Term Pregnancy ◽  
Meconium Stained Amniotic Fluid ◽  
Control Study

BACKGROUND Meconium stained amniotic fluid is a significant contributor to perinatal and neonatal morbidity and mortality. The study was conducted to determine the risk factors of meconium stained amniotic fluid in term pregnancy. METHODS This study is a prospective case control study done in a tertiary care hospital in South India over a period of one year. 100 women with meconium stained amniotic fluid detected at any time during the course of labour, prior to it or meconium detected in hind waters were enrolled in the study group. The inclusion criteria were term pregnancy, cephalic presentation and singleton pregnancy. 200 women who satisfied the same set of inclusion criteria with clear amniotic fluid, selected on random basis were taken as controls. A standardised pretested proforma was used for data collection. RESULTS In the study, incidence of grade 1, grade 2 and grade 3 meconium were 31 %, 42 % and 27 % respectively. 83 % of cases were in the 20 – 24 year age group and advanced maternal age was not a risk factor in the study. Primiparity (86 % cases vs. 47 % controls) and advanced gestational age (56 % cases and 33 % controls) were significant risk factors. Maternal obesity, socioeconomic status and treatment for infertility were not significant risk factors. Among medical disorders, gestational diabetes mellitus (21 % cases vs. 5 % controls), gestational hypertension (12 % vs. 3.5 %) and hypothyroidism (13 % cases vs. 4.5 % controls) showed statistical significance. Oligoamnios (9 % vs. 1 %), fetal growth restriction (13 % vs. 4.5 %) and maternal infection (12 % vs. 2 %) were significant risk factors. Induced labour and prolonged labour were the significant intrapartum risk factors. Caesarean section rates were nearly doubled in cases (40 %) compared to controls (21.5 %). Babies born to mothers with meconium stained amniotic fluid had low Apgar scores at birth (25 %) and increased neonatal intensive care unit (NICU) admission. CONCLUSIONS Meconium stained amniotic fluid is associated with increased rates of maternal morbidity due to higher rates of operative deliveries and increased incidence of perinatal asphyxia, perinatal morbidity and mortality. Meticulous antenatal care and early identification of risk factors help in reducing the incidence of meconium stained amniotic fluid and preventing adverse maternal and neonatal outcome. KEYWORDS Risk Factors, Meconium, Amniotic Fluid, Term Pregnancy, Caesarean Section, Perinatal Outcome

scholarly journals Maternal and fetal outcome in term labour with meconium stained amniotic fluid

2012 ◽  
Vol 10 (3) ◽  
pp. 198-202
Author(s):  
S Kumar ◽  
SN Gupta ◽  
IP Mahato ◽  
R Giri ◽  
A Yadav ◽  
...  
Keyword(s):  
Amniotic Fluid ◽  
Mode Of Delivery ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Delivery Methods ◽  
Normal Delivery ◽  
Term Labour ◽  
Meconium Stained Amniotic Fluid ◽  
Control Study ◽  
Additional Monitoring

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

scholarly journals Mode of delivery and fetal outcome in meconium stained amniotic fluid in DMCH

2018 ◽  
Vol 9 (2) ◽  
pp. 304-307 ◽  
Author(s):  
Fazilatun Nesa ◽  
Fahmida Chowdhury ◽  
BH Nazma Yasmeen ◽  
Shabnam Rahman ◽  
Nasreen Begum ◽  
...  
Keyword(s):  
Amniotic Fluid ◽  
Mode Of Delivery ◽  
Neonatal Resuscitation ◽  
Fetal Outcome ◽  
College Hospital ◽  
Medical College ◽  
Rh Incompatibility ◽  
Long Time ◽  
The Mean ◽  
Meconium Stained Amniotic Fluid

Background : Meconium is a dark greenish mass of desquamated cells, mucus, and bile that accumulates in the bowel of a fetus and is typically discharged shortly after birth. Meconium stained amniotic fluid (MSAF) has long been considered to be a bad predictor of fetal outcome.Objective : The aim of this study was to determine if the perinatal outcome is affected by mode of delivery in meconium-stained amniotic fluid.Methodology : This ovservational study was carried out in the department of Obstetrics and Gynaecology in Dhaka Medical College Hospital from July 2016 to June 2017. A total of 204 women who satisfied the inclusion and exclusion criteria were taken for the study. The study group comprised of 102 women admitted in labour and having meconium stained amniotic fluid and 102 women in labour but having clear amniotic fluid were taken as comparision group.Results : The mean age was found 26.6±5.9 years in MSAF group and 26.2±5.0 years in clear liquor group. The mean gestational age was found 38.9±1.8 weeks in MSAF group and 38.5±1.3 weeks in clear liquor group. Risk factors were not statistically significant (p>0.05) between two groups. Forty-one (40.2%) patients had caesarian section in MSAF group and 19(18.6%) in clear liquor group. APGAR score at 1 minute and at 5 minute were statistically significant (p<0.05) between two groups. About 100(98.0%) babies were alive in MSAF group and 101(99.0%) in clear liquor group.Conclusion : Meconium stained amniotic fluid group was associated with higher rate of cesarean delivery, increased need for neonatal resuscitation, increased rate of PIH, pre-eclamsia, Oligohydramnios, IUGR, Post dated pregnancy, Rh incompatibility, GDM and long time hospital stay and hospital mortality.Northern International Medical College Journal Vol.9(2) Jan 2018: 304-307

scholarly journals Meconium stained liquor and fetal outcome: a hospital based follow up study

2019 ◽  
Vol 8 (6) ◽  
pp. 2434
Author(s):  
P. Kalpana ◽  
A. Kavitha
Keyword(s):  
Amniotic Fluid ◽  
Apgar Score ◽  
Neonatal Morbidity ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Meconium Aspiration Syndrome ◽  
Chi Square ◽  
Mortality And Morbidity ◽  
Meconium Staining ◽  
Meconium Stained Amniotic Fluid

Background: Meconium staining of the amniotic fluid is a common problem occurring in 10-22% of all deliveries. Meconium aspiration syndrome complicates approximately 1.5% of these deliveries with a reported mortality rate as high as 40%. Objectives of the study were to determine whether meconium stained liquor during labour is associated with fetal distress and to check if there is any correlation in between the degree of meconium staining liquor and fetal outcome.Methods: A clinical study of 200 cases of meconium stained amniotic fluid in cephalic presentation was undertaken among patients who were admitted in labour room were examined in detail and investigations were done. Fetal heart rate and its pattern were noted every fifteen min. Total APGAR score at one minute and five minute was noted down. Odds ratio with 95% confidence interval was calculated. Proportions were analyzed using chi square value.Results: Majority of the study subjects belonged to the age group of 21-30 years. Majority i.e. 54.5% were multigravida. Majority had toxemia in 24% of the cases. Fetal distress and the incidence of forceps delivery or LSCS was significantly more in those with thick meconium compared to those with thin meconium (p<0.05). But fetal asphyxia was not associated with type of stained meconium. It is seen that as the duration of the meconium staining increased, the proportion of babies with low APGAR score, perinatal mortality and morbidity increased.Conclusions: Thick meconium stained amniotic fluid was associated with increased rate of interventions, neonatal morbidity and mortality compared to thin meconium stained meconium fluid.

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
Keyword(s):  
Respiratory Distress ◽  
Amniotic Fluid ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Neonatal Outcome ◽  
Mode Of Delivery ◽  
Age At Onset ◽  
In Utero ◽  
Severe Thrombocytopenia ◽  
Meconium Stained Amniotic Fluid

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.

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