scholarly journals Association of gestational age, Apgar score and neonatal outcomes in newborns with meconium stained amniotic fluid

2019 ◽  
Vol 6 (4) ◽  
pp. 1563
Author(s):  
Preeti Garg ◽  
Devendra Barua ◽  
Shruti Saxena
Keyword(s):  
Amniotic Fluid ◽  
Gestational Age ◽  
Apgar Score ◽  
Tertiary Care ◽  
Neonatal Outcomes ◽  
Control Group ◽  
Study Group ◽  
Increased Risk ◽  
The Mean ◽  
Meconium Stained Amniotic Fluid

Background: Infants born with meconium stained fluid are at increased risk of fetal hypoxia, evidenced by increased rates of abnormalities indicated by fetal monitoring in labor, low neonatal Apgar scores, and fetal deaths. The study is conducted to determine association of gestational age, Apgar score and neonatal outcomes in newborn born with meconium stained amniotic fluid in tertiary care centre of central India.Methods: The study was conducted over a period of 2 years from January 2012 to January 2014 in Department of Pediatrics, Sri Aurobindo Medical College and Hospital, Indore, Madhya Pradesh, India. One hundred newborns with meconium stained amniotic fluid (study group) and one hundred newborns with clear amniotic fluids (control group) were studied in this period. Gestational age, Apgar score and neonatal outcomes were compared among two groups.Results: The mean gestational age in study group was 38.89±1.14 weeks and in control group was 38.59±0.99 weeks. The mean Apgar score at 1 min was 5.80±1.59 in study group and in the control group was 7.86±0.35. 32 babies in meconium stained liquor had hypoxia of which 11 had respiratory distress, 11 required mechanical ventilation (MAS 08, sepsis 03), 2 newborns had HIE stage 2 and 5 patients died. The above findings suggest higher gestational age, lower Apgar score and poor neonatal outcomes are associated with meconium stained liquor.Conclusions: The study depicts significant co-relation with higher gestational age, lower Apgar at 1 and 5 minutes and poor neonatal outcome in babies with meconium stained amniotic fluid.

scholarly journals Perinatal outcome in meconium-stained amniotic fluid at term: a single center prospective study

2020 ◽  
Vol 10 (1) ◽  
pp. 107
Author(s):  
Vandana Mohapatra ◽  
Sujata Misra ◽  
Tapas Ranjan Behera
Keyword(s):  
Caesarean Section ◽  
Amniotic Fluid ◽  
Pregnant Women ◽  
Perinatal Outcome ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Control Group ◽  
Study Group ◽  
The Mean ◽  
Meconium Stained Amniotic Fluid

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.

scholarly journals Correlation study between increased fetal movement during the third trimester and neonatal outcome

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Cuiqin Huang ◽  
Wei Han ◽  
Yajing Fan
Keyword(s):  
Amniotic Fluid ◽  
Pregnant Women ◽  
Gestational Age ◽  
Neonatal Outcome ◽  
Stress Test ◽  
Neonatal Outcomes ◽  
Control Group ◽  
Third Trimester ◽  
The Third ◽  
Fetal Movements

Abstract Background We aimed to analyze the correlation between increased fetal movements in the third trimester and neonatal outcomes. Methods We enrolled pregnant women (n = 219) who reported increased/excessive fetal movements in the third trimester in our hospital. A control group of healthy women (n = 278) who had undergone regular childbirth and delivery in our hospital during the same period and did not report abnormal fetal movements were also recruited. All pregnant women underwent fetal non-stress test. We analyzed the neonatal weight, appearance, pulse, grimace, activity, and respiration score, degrees of amniotic fluid contamination, amniotic fluid volume, conditions of umbilical cord around the neck and cord length, and incidence of small for gestational age. In addition, the incidence of preterm delivery, cesarean section rate, postpartum hemorrhage, and other postpartum complications were also analyzed. We then analyzed the correlation between increased/excessive fetal activity and neonatal outcomes. Results Women with complaints of increased/excessive fetal movements exhibited increased fetal movements mainly around 31 and 39 weeks of gestation. Several pregnancy variables, including number of previous delivery, gestational age (less than 34 weeks and more than 37 weeks) and vaginal birth rate, were associated with increased/excessive fetal movements. In addition, women who reported increased/excessive fetal movements had higher odds of large for gestational age (LGA), particularly those with gestational age over 37 weeks. Conclusion Increased/excessive fetal movements may be used to predict adverse neonatal outcome such as LGA.

scholarly journals Preterm Birth and Small-for-Gestational Age Neonates among Prepregnancy Underweight Women: A Case-Controlled Study

2021 ◽  
Vol 10 (24) ◽  
pp. 5733
Author(s):  
Emelyne Lefizelier ◽  
Emilie Misbert ◽  
Marion Brooks ◽  
Aurélie Le Thuaut ◽  
Norbert Winer ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Tertiary Care ◽  
Multivariable Analysis ◽  
Controlled Study ◽  
Control Group ◽  
Study Group ◽  
Retrospective Case ◽  
Prepregnancy Bmi

The aim of our study was to investigate whether prepregnancy underweight body mass index (BMI) is associated with preterm birth (PTB) and small-for-gestational age (SGA). This retrospective case-control study included 814 women with live singleton fetuses in vertex presentation that gave birth between January 2016 and November 2016 in two tertiary care hospitals. The study group (n = 407) comprised all women whose prepregnancy BMI was underweight (<18.5 kg/m2) and who delivered during the study period. A control group (n = 407) was established with women whose prepregnancy BMI was normal (18.5–24.9 kg/m2) by matching age and parity. Univariate and multivariate analyses were performed to compare PTB and SGA associated with prepregnancy underweight BMI. Compared with the control group, the study group had higher rates of overall PTB (10.1% vs. 5.7%, p = 0.02), iatrogenic PTB (4.2% vs. 1.5%, p = 0.02), and SGA (22.1% vs. 11.1%, p < 0.001). In a multivariable analysis, prepregnancy underweight BMI was associated with PTB (aOR 2.32, 95% CI 1.12–4.81) and with SGA (aOR 2.38, 95% CI 1.58–3.58). In singleton pregnancies, women’s prepregnancy underweight compared with normal BMI was associated with an increase in PTB and in SGA neonates. Identifying this specific high-risk group is pragmatic and practical for all physicians, and they should be aware about perinatal outcome among underweight women.

scholarly journals Successful External Cephalic Version: Factors Predicting Vaginal Birth

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Pei Shan Lim ◽  
Beng Kwang Ng ◽  
Anizah Ali ◽  
Mohamad Nasir Shafiee ◽  
Nirmala Chandralega Kampan ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Gestational Age ◽  
Caesarean Section Rate ◽  
Vaginal Birth ◽  
External Cephalic Version ◽  
Control Group ◽  
Study Group ◽  
Amniotic Fluid Index ◽  
Additional Information ◽  
The Mean

Purpose. To determine the maternal and fetal outcomes of successful external cephalic version (ECV) as well as factors predicting vaginal birth.Methods. The ECV data over a period of three years at Universiti Kebangsaan Malaysia Medical Centre (UKMMC) between 1 September 2008 and 30 September 2010 was reviewed. Sixty-seven patients who had successful ECV were studied and reviewed for maternal, fetal, and labour outcomes. The control group comprised patients with cephalic singletons of matching parity who delivered following the index cases.Results. The mean gestational age at ECV was263±6.52 days (37.5 weeks ± 6.52 days). Spontaneous labour and transient cardiotocographic (CTG) changes were the commonest early adverse effects following ECV. The reversion rate was 7.46%. The mean gestational age at delivery of the two groups was significantly different (P=0.000) with277.9±8.91days and269.9±9.68days in the study group and control groups, respectively. The study group needed significantly more inductions of labour. They required more operative deliveries, had more blood loss at delivery, a higher incidence of meconium-stained liquor, and more cord around the neck. Previous flexed breeches had a threefold increase in caesarean section rate compared to previous extended breeches (44.1% versus 15.2%,P=0.010). On the contrary, an amniotic fluid index (AFI) of 13 or more is significantly associated with a higher rate of vaginal birth (86.8% versus 48.3%,P=0.001).Conclusions. Patients with successful ECV were at higher risk of carrying the pregnancy beyond 40 weeks and needing induction of labour, with a higher rate of caesarean section and higher rates of obstetrics complications. Extended breech and AFI 13 or more were significantly more likely to deliver vaginally postsuccessful ECV. This additional information may be useful to caution a patient with breech that ECV does not bring them to behave exactly like a normal cephalic, so that they have more realistic expectations. However, these predictive factors needed further confirmation and hopefully, in the future, they would be able to further enhance counselling prior to ECV.

scholarly journals Clinical profile of babies with meconium stained amniotic fluid

2017 ◽  
Vol 5 (10) ◽  
pp. 4319
Author(s):  
Defairlin Ranee ◽  
Deepa S. Phirke
Keyword(s):  
Amniotic Fluid ◽  
Strong Association ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Fetal Distress ◽  
Meconium Aspiration Syndrome ◽  
Clinical Profile ◽  
Meconium Aspiration ◽  
Increased Risk ◽  
Meconium Stained Amniotic Fluid

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.

scholarly journals A randomised single blind control study to assess the effect of intrapartum amnioinfusion on maternal caesarean section rate and fetal outcome in a tertiary care centre

2017 ◽  
Vol 6 (10) ◽  
pp. 4347
Author(s):  
Michelle Fonseca ◽  
Jyotsna S. Dwivedi
Keyword(s):  
Caesarean Section ◽  
Caesarean Section Rate ◽  
Tertiary Care ◽  
Fetal Outcome ◽  
Meconium Aspiration Syndrome ◽  
Control Group ◽  
Study Group ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Meconium Stained Amniotic Fluid

Background: The procedure of instilling normal saline/Ringer’s lactate into the uterine cavity is called amnioinfusion. Objective of present study was to assess the effect of intrapartum amnioinfusion on maternal caesarean section rate and fetal outcome in a tertiary care centre in cases of meconium stained amniotic fluid.Methods: A total of 160 women at term in labor with meconium stained amniotic fluid were randomized into two groups: study and control group. The study group received transcervical amnioinfusion at detection of MSAF. The control group was given the routine obstetric care. Both groups were started on O2 and intrapartum monitoring. The outcomes in both groups were analyzed statistically.Results: The control group had caesarean section rate of 45% and in the study group it was 31.25%. The difference was statistically significant. The outcome in the neonate was assessed on the parameters such as respiratory distress, neonatal intensive care unit admission, meconium aspiration syndrome, neonatal deaths.Conclusions: Amnioinfusion in cases of meconium stained amniotic fluid cases significantly reduces the risk of meconium aspiration syndrome. It also decreases the need for operative intervention thus reducing the risk of maternal morbidity and mortality.

scholarly journals Comparison of hematological parameters among newborns with meconium stained amniotic fluid and clear amniotic fluid

2019 ◽  
Vol 6 (6) ◽  
pp. 2480
Author(s):  
Preeti Garg ◽  
Shruti Saxena
Keyword(s):  
Amniotic Fluid ◽  
Hematological Parameters ◽  
Surrogate Marker ◽  
Hematological Parameter ◽  
Control Group ◽  
Study Group ◽  
Fetal Hypoxia ◽  
Nucleated Red Blood Cells ◽  
Resource Limited ◽  
Meconium Stained Amniotic Fluid

Background: Meconium stained amniotic fluid is an indirect marker of fetal hypoxia. Fetal hypoxia affects bone marrow and affects production of cell lines. Indirect marker of erythropoietin activity is nucleated red blood cells count. Aim of the study is to compare hematological parameter in newborn born with meconium stained liquor and clear amniotic fluid. Also, to determine cut off levels of nucleated RBC as marker of fetal hypoxia in meconium stained amniotic fluid(MSAF).Methods: The study was conducted over a period of 2 years from January 2012 to January 2014 in Department of Pediatrics, Sri Aurobindo medical college and hospital, Indore. One hundred newborns with meconium stained amniotic fluid (study group) and one hundred newborns with clear amniotic fluids (control group) were studied in this period. Cord blood samples were collected and hematological parameters were compared.Results: Hemoglobin % and WBC counts were seen in study group in comparison to control group, which is statistically significant (P<0.05). The reported NRBC/100 WBC between the two groups was statistically analyzed. The mean NRBC count in study group were 8.09±6.09 which was statistically higher than the corresponding values in control group 2.07±2.25 (P<0.05).Conclusions: Study concluded that the hemoglobin levels , WBC and NRBC counts in babies with meconium stained amniotic fluid is higher than those babies delivered with clear amniotic fluid and NRBC can be taken as a surrogate marker of hypoxia in a resource limited setting.

scholarly journals Outcome of expectantly managed small-for-gestational-age pregnancies with normal Doppler parameters- a prospective cohort study

2021 ◽  
Vol 10 (3) ◽  
pp. 1134
Author(s):  
Sneha Mishra ◽  
Krishna Agarwal
Keyword(s):  
Birth Weight ◽  
Caesarean Section ◽  
Gestational Age ◽  
Expectant Management ◽  
Control Group ◽  
P Value ◽  
Study Group ◽  
Biophysical Profile ◽  
Group 3 ◽  
The Mean

Background: SGA foetuses with normal Dopplers are not at risk of IUD. However, there is lack of consensus about timing of delivery of SGA foetuses. Clinicians commonly induce all SGA pregnancies at 37 weeks. Expectant management of SGA foetuses beyond 37 weeks is not well studied.Methods: We followed up women with clinically suspected growth restriction with foetal biometry, Doppler and biophysical profile. Pregnancies with foetal AC between 10th to 3rd centile with normal Dopplers were recruited in the study group. The women were allowed to go in spontaneous labor till 39+6/7 weeks or were induced at 39+6/7 weeks. The outcome of such cases was compared with controls who were induced at 37+0/7 weeks.Results: Spontaneous labor occurred in 42% subjects in study group whereas in control group all were induced. Mean gestation at delivery in the study group was increased (39.57±0.71 versus 37.0±0.0, p value <0.001). Almost 81% of the subjects in study group delivered after 39 weeks. The rate of caesarean section was significantly lower in study group (3% versus 22%, p value-0.024). Also, the risk of intrapartum foetal distress was lower in study group (3/36 versus 1/36).The mean birth weight in the study group was higher (2426.5±154.1 gm versus 2297.9±101.4 gm, p value <0.001.Conclusions: Expectant management of SGA pregnancies with normal Doppler parameters leads to a significant increase in gestational age at birth and the mean birth weight and a significant reduction in caesarean section rate. 

scholarly journals COMPARISON OF PERINATAL OUTCOME IN TWIN PREGNANCY WITH AND WITHOUT CERVICAL CERCLAGE

2020 ◽  
pp. 48-52
Author(s):  
Kalpana Damor ◽  
Sandhaya Choudhary ◽  
Himanshi Gangwal
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Low Birth Weight ◽  
Apgar Score ◽  
Twin Pregnancy ◽  
Control Group ◽  
Study Group ◽  
Second Trimester ◽  
Cervical Cerclage ◽  
The Mean

Background: The incidence of multifetal pregnancies has registered increase globally. Babies born from multiplebirth pregnancies are much more likely to result in premature birth than those from single pregnancies. Knowledge of role of cervical cerclage in preventing preterm birth especially in twin pregnancy can be helpful to prevent complication related to preterm birth and ultimately of low birth weight babies. Methods: Depending upon who opt for the procedure 100 patients were divided equally into two groups: 1)Twin pregnancy with cervical cerclage; 2)Twin pregnancy without cervical cerclage. We measured maternal outcomes which include time for which patient required to be hospitalized, maternal pyrexia, cervical or bladder injury and other maternal morbidity and perinatal outcomes which include preterm delivery (delivery before 37 completed weeks), low birth weight (birth weight ≤2000 g), IUGR, perinatal mortality, indicators of perinatal morbidity (APGAR scores and neonatal unit admission), stillbirth, second trimester loss and presence of congenital malformations. Results: In Study group 22% delivered before 34 weeks of gestation, 46% delivered between 34 and 37 weeks of gestation, 32% delivered after 37 weeks of gestation compared to 44%, 48% and 8% respectively in Control group. The mean gestational age at delivery was 35.3 weeks in Study group and was 33.2 weeks in Control group. In study group 47% neonates had birth weight less than 2Kg and in Control group 69% neonates had birth weight less than 2Kg. In Study group 95% had Apgar score more than 6 whereas in Control group 86% had APGAR score more than 6. The mean APGAR for Study group was 8.5 and for Control group was 7.5. 45% neonates had complications in Study group whereas 67% neonates in Control group. Overall Low birth weight was most common complications in both the groups. Respiratory distress was more common in Control group. Conclusions: In spite of close vigilance, preterm birth in twin gestation is common and unpredictable. It is difficult to predict those who may require cervical cerclage although all multiple pregnancies are at high risk. Cerclage should be considered an option for patients with twin pregnancies in the second trimester to prolong the duration of gestation as close to term as possible.

scholarly journals Do Large Uterine Fibroids Impact Pregnancy Outcomes?

2021 ◽  
Vol 36 (4) ◽  
pp. e292-e292
Author(s):  
Ruqaiya Al Sulaimani ◽  
Lovina Machado ◽  
Munira Al Salmi
Keyword(s):  
Preterm Delivery ◽  
Postpartum Hemorrhage ◽  
Uterine Fibroids ◽  
Neonatal Outcomes ◽  
Control Group ◽  
Study Group ◽  
Significant Difference ◽  
History Of ◽  
The Mean ◽  
Cesarean Myomectomy

Objectives: We sought to assess the prevalence of fibroids complicating pregnancy among Omani women who delivered and were followed-up at Sultan Qaboos University Hospital (SQUH) and correlate the presence of large fibroids (> 5 cm) with maternal and neonatal outcomes. Methods: This retrospective cohort study was conducted at the Department of Obstetrics and Gynecology, SQUH, from 1 January 2011 to 31 December 2016. Demographic data included maternal age, gravidity, parity, body mass index (BMI), and history of preterm delivery. Ultrasonographic data included the total number of fibroids, number of fibroids > 5 cm in diameter, and location. The main outcomes measured were preterm delivery, preterm premature rupture of membranes (PPROM), malpresentation, intrauterine growth restriction (IUGR), mode of delivery, postpartum hemorrhage, retained placenta, and cesarean myomectomy. Fetal outcomes included birth weight and Apgar score. We used the chi-square test and t-test to calculate significant outcomes. Results: The total number of deliveries over the study period was 24 800. Among these, 62 women had fibroids complicating pregnancy, giving an overall prevalence of 0.3%. Of the 62 women with documented uterine fibroids, 41 had fibroids > 5 cm in diameter and formed the study group, while the control group included 88 women with no fibroids and normal singleton pregnancies. The mean age, parity, BMI, and history of preterm delivery were comparable. The mean age of the study group was 32.6 years. There was no statistically significant difference in obstetric outcomes between the study and control group in terms of preterm labor (p =0.381), PPROM (p =0.536), malpresentation (p =0.237), IUGR (p =0.059), and retained placenta (p =0.296). Postpartum hemorrhage was significantly higher in the study group (p =0.018), the commonest cause was uterine atony (p =0.007). Women with large fibroids had a significantly increased cesarean section rate (p =0.002), the main indications were obstructed labor and failure to progress (62.5%). Five of the 44 women in the study group (12.8%) underwent cesarean myomectomy. Regarding neonatal outcomes, a statistically significant difference was noted in the Apgar scores. Conclusions: Fibroids measuring > 5 cm in diameter are more likely to cause obstetric complications and are associated with higher cesarean rates. Pre-conception myomectomy is recommended for women with large fibroids.

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