scholarly journals Risk Factors and Outcome of Neonates Born through Meconium Stained Amniotic Fluid in a Tertiary Hospital of Nepal

2015 ◽  
Vol 35 (1) ◽  
pp. 44-48 ◽  
Author(s):  
SM Gurubacharya ◽  
S Rajbhandari ◽  
R Gurung ◽  
A Rai ◽  
M Mishra ◽  
...  

Introduction: The incidence of meconium aspiration syndrome is still high in the developing world contributing significantly to the neonatal mortality. The study was aimed to know the risk factors contributing to meconium aspiration syndrome and neonatal outcome in a tertiary government hospital of the country.Materials and Methods: It was a hospital based cross sectional study done over a period of three months. All live newborns born through meconium stained liquor were enrolled and all the details regarding mother, neonate were recorded. Odd’s ratio and bivariate analysis was done to assess the risk factors for meconium aspiration syndrome.Result: Out of all the deliveries 14.6% were meconium stained amniotic fluid and meconium aspiration syndrome developed in 6.6% of the neonates. Low Apgar score and premature rupture of membranes was significantly associated with the risk of occurrence of meconium aspiration syndrome. Neonates who developed meconium aspiration syndrome had mortality of 11.3%.Conclusion: Perinatal asphyxia and premature rupture of membranes were significantly associated with the development of meconium aspiration syndrome and neonates who developed meconium aspiration syndrome had high mortality.J Nepal Paediatr Soc 2015;35(1):44-48

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.


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 6 (1) ◽  
pp. 144 ◽  
Author(s):  
Milind B. Kamble ◽  
Poonam Jain

Background: Meconium aspiration syndrome (MAS) is a life-threatening respiratory disease affecting some neonates born through meconium-stained amniotic fluid (MSAF). MSAF complicates delivery in approximately 8% to 25% of live births, of which nearly 5% of the neonates born through MSAF develop MAS. The present study was undertaken to find out the prevalence of MSAF and MAS and to study the etiology, risk factors, clinical profile and outcome of MAS.Methods: By purposive sampling technique, all newborns, fulfilling the inclusion criteria during one year of study period were enrolled in this hospital based cross-sectional observational study. Risk factors and clinical profile were compared between those who died and survived.Results: Out of 8765 deliveries in hospital 1220 neonates were born with MSAF of which 94 neonates had MAS. Thereby, incidence of MSAF was 13.9% and incidence of MAS out of MSAF was 7.7 %. Of the 94 neonates who had MAS 13.82% died. Almost 3/4th of the MAS neonates were term and AGA. MAS were more common in primigravida mother (68%) and LSCS deliveries (53.2%). Of the total MAS 54.2% had thick meconium in whom mortality was 92.3%. The mortality in MAS cases was significant in low 5-minute APGAR score and non-vigorous baby.Conclusions: Since MSAF is associated with higher morbidity and mortality, if the knowledge of risk factors is known to health care personnel then timely referral or intervention can help in decreasing MAS and its complications.


2021 ◽  
Vol 11 (33) ◽  
pp. 128-138
Author(s):  
Lilia Cristina Pantoja de Araújo ◽  
Angeline Do Nascimento Parente ◽  
Ruan Matheus Silva de Freitas ◽  
Andressa Tavares Parente ◽  
Rosângela Santana Moraes ◽  
...  

A asfixia perinatal, causada pela Síndrome de Aspiração Meconial, é uma das principais causas de mortalidade neonatal precoce em recém-nascidos de baixo risco e sem anomalias congênitas. O objetivo da pesquisa foi definir o perfil e a ocorrência de reanimação neonatal de recém-nascidos em Líquido Amniótico Meconial de uma maternidade de referência materno infantil. Estudo quantitativo, retrospectivo documental realizado com 47 prontuários de recém-nascido selecionados mediante a presença de Líquido Amniótico Meconial ao nascimento. Na amostra: 55,3% a termo; 51,5% do sexo masculino; 55,3% via parto cesáreo; 48,9% com peso adequado para a idade gestacional; 78,7% não precisou de Aspiração sob Visualização Direta da Traqueia. Índice de Apgar menor que 7 pontos no primeiro minuto de vida foram 93,6 %, mas com melhora no quinto minuto de vida. Observa-se a importância de conhecer o perfil destes neonatos para proporcionar um atendimento qualificado.Descritores: Líquido Amniótico, Mecônio, Recém-Nascido. Neonates born through meconium stained amniotic fluid: variables and interventionsAbstract: Perinatal asphyxia, caused by Meconium Aspiration Syndrome (MAS), is one of the main causes of early neonatal mortality in low risk newborns and without congenital abnomalities. The goal of this research was to define the profile and the occurrence of neonatal resuscitation of neonates born on Meconium Stained Amniotic Fluid (MSAF) in a maternal hospital child care reference. This is a quantitative, retrospective documentary study performed based in 47 medical records of newborns selected through the presence of Meconium Stained Amniotic Fluid (MSAF) at the birth. In the specimen it was found that: 55.3% were born at term; 51.5% were male; 55.3% by way of cesarean; 48.9% with adequate weight for gestational age (AGA); 78.7% did not need aspiration under Direct Tracheal Visualization. It was identified that 93.6% had an Apgar score less than 7 points in the first minute of life, but with improvement in the fifth minute of life. It is noted the importance of knowing the profile of these newborns to provide qualified care.Descriptors: Amniotic Fluid, Meconium, Newborn. Recién nacido en líquido amniotico meconial: variables e intervencionesResumen: La asfixia perinatal, causada por el Síndrome de Aspiración Meconial, es una de las principales causas de mortalidad neonatal temprana en recién nacidos de bajo riesgo y sin anomalías congénitas. El objetivo de la investigación fue definir el perfil y la ocurrencia de la reanimación neonatal de recién nacidos en líquido amniótico meconial en un hospital de maternidad de referencia materno-infantil. Estudio cuantitativo, retrospectivo documental realizado con 47 registros médicos de recién nacidos seleccionados mediante la presencia de líquido amniótico meconial al nacer. En la muestra: 55,3% a término; 51.5% eran de género masculino; 55.3% por cesárea; 48,9% con peso adecuado para la edad gestacional; 78.7% no necesitaron aspiración mediante visualización directa de las traqueas. 93,6% presentaron puntuación de Apgar inferior a 7 puntos en el primer minuto de vida, pero con una mejora en el quinto minuto de vida. Se destaca la importancia de conocer el perfil de estos recién nacidos para proporcionar atención calificada.Descriptores: Líquido amniótico, Meconio, Recién Nacido.


2019 ◽  
Vol 6 (3) ◽  
pp. 1330
Author(s):  
Siva Saranappa S. B. ◽  
Shiva Devaraj ◽  
Nithya E.

Background: The incidence of meconium stained amniotic fluid is 8-20% among all deliveries. The Aspiration of meconium into the airway results in various short term and long term morbidities and mortality. Timely management of these neonates with meconium in amniotic fluid may prevent Meconium aspiration syndrome.Methods: This prospective cohort study was conducted at Kempegowda Institute of Medical Sciences, Bangalore. All live Term neonates born between December 2016 and July 2018 with meconium in amniotic fluid were enrolled in the study. Details of the neonate was entered in the pre-designed Proforma. The objective of this study the outcome of MAS neonates and find factors associated with Meconium aspiration syndrome when compared with Meconium stained amniotic fluid neonates as a whole. These associated factors were presented as Odds Ratio (OR) and 95% Confidence Interval. Chi-square test was done where applicable and a p-value <0.05 was taken as significant.Results: Meconium aspiration syndrome was seen in 79 out of the 188 neonates born with meconium stained amniotic fluid.Conclusions: The morbidity and mortality in a neonate with Meconium stained amniotic fluid (MSAF) to develop meconium aspiration syndrome (MAS) can be avoided with timely antenatal care. Meconium-stained babies should be aggressively managed to prevent complications like perinatal asphyxia and respiratory failure which may lead to the mortality. Those neonates with risk for adverse outcome should be managed with special focus on respiratory care with use of assisted ventilation and inhaled nitric oxide and extracorporeal membrane oxygenation, where available.


2020 ◽  
Vol 10 (01) ◽  
pp. e207-e211
Author(s):  
Suzan Gad ◽  
Abeer Alkhalafawi ◽  
Syed Raza ◽  
Mervat Hesham ◽  
Mohamed Sheta

AbstractMeconium aspiration syndrome (MAS) is a serious neonatal condition. Prediction of MAS is challenging particularly in low-resource setting. Neutrophil to lymphocyte ratio (NLR) is a new simple index used for diagnosis of many inflammatory conditions. The present study was an attempt to determine whether NLR can predict the occurrence of MAS. The present study included 101 children with meconium-stained amniotic fluid. They comprised 22 patients who developed MAS and 79 neonates who didn't have the condition. All neonates were subjected to careful analysis of maternal and perinatal history in addition to thorough clinical assessment and radiological and laboratory evaluation. Blood samples from the umbilical cord were collected at birth and were used to obtain complete blood counts and C-reactive protein (CRP) assay. Univariate analysis revealed that elevated CRP levels, increased NLR, and 5-minute Apgar score of <7 were significant risk factors for the occurrence of MAS. Multivariate analysis revealed that low 5-minute Apgar score and increased NLR remained as significant risk factors of MAS. Receiver operating characteristic curve analysis showed good performance of NLR in prediction of MAS. NLR is useful in prediction of MAS in term neonates with meconium-stained amniotic fluid.


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