scholarly journals Neonatal Outcome in Meconium Stained Amniotic Fluid (MSAF): A Study in a Neonatal High Dependency Unit (NHDU) of a Medical College Hospital

Mediscope ◽  
2019 ◽  
Vol 6 (2) ◽  
pp. 65-71
Author(s):  
MB Ali ◽  
AA Maruf ◽  
N Naher ◽  
S Islam
Keyword(s):  
Amniotic Fluid ◽  
Birth Asphyxia ◽  
Meconium Aspiration Syndrome ◽  
Maternal Risk Factors ◽  
College Hospital ◽  
Maternal Risk ◽  
Medical College ◽  
High Dependency ◽  
Meconium Stained Amniotic Fluid ◽  
Ischemic Encephalopathy

Background: Meconium-stained amniotic fluid (MSAF) is a potential sign of fetal hypoxia as well as a potential toxin if the fetus aspirates with a gasping breath in utero or when it takes its first breaths following birth. Objective: To evaluate the outcome of neonates with meconium-stained amniotic fluid (MSAF). Material and Methods: This prospective observational study was carried out in the department of pediatrics of Gazi medical college Hospital, Khulna during one calendar year from 01 July 2016 to 30 June 2017. Maternal risk factors for MSAF, modes of delivery of neonates were recorded. All neonates born with MSAF were included in this study: they were shifted to neonatal high dependency unit for observation and monitoring as per the pediatrician’s advice. Neonatal outcomes like birth asphyxia, neonatal jaundice, aspiration pneumonia, septicemia, meconium aspiration syndrome (MAS), hypoxic-ischemic encephalopathy (HIE) and death were observed and recorded. Result: A total of 157 babies were included during the study period. Modes of delivery of babies were: normal delivery 86(54.78%), caesarean section 48(30.57%) and instrumental delivery 23(14.65%). Maternal risk factors were postdated pregnancy 51(32.48%), previous caesarian section 20(12.74%), pregnancy-induced hypertension (PIH) 20(12.74%), premature rupture of membranes 18(11.46%), gestational diabetes mellitus (GDM) 17(10.83%), intrauterine growth retardation (IUGR) 14 (8.92%), cephalopelvic disproportion 9(5.73%) and anemia 8(5.10%). Outcome of babies were: 118(75.16%) babies were discharged without any complications, 10(6.37%) developed neonatal jaundice, 10(6.37%) meconium aspiration syndrome (MAS), 8(5.10%) birth asphyxia, 4(2.55%), aspiration pneumonia, 3(1.91%) hypoxic-ischemic encephalopathy (HIE), 2(1.27%) septicemia and 2(1.27%) baby died in early neonatal period. Mediscope Vol. 6, No. 2: Jul 2019, Page 65-71

scholarly journals A study of maternal risk factors and the perinatal outcome in meconium stained amniotic fluid in central referral hospital

2019 ◽  
Vol 8 (11) ◽  
pp. 4146
Author(s):  
Kapil Singh Niranjan ◽  
Pesona Grace Lucksom
Keyword(s):  
Risk Factors ◽  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Significant Risk ◽  
Birth Asphyxia ◽  
Meconium Aspiration Syndrome ◽  
Meconium Aspiration ◽  
Maternal Risk ◽  
Prolonged Labor ◽  
Meconium Stained Amniotic Fluid

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.

scholarly journals Clinical study of babies born through meconium stained amniotic fluid

2019 ◽  
Vol 6 (2) ◽  
pp. 491 ◽  
Author(s):  
Shilpasri Y. M. ◽  
Madhurya B.
Keyword(s):  
Amniotic Fluid ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Fetal Monitoring ◽  
Fetal Distress ◽  
Fetal Outcome ◽  
Meconium Aspiration Syndrome ◽  
Meconium Aspiration ◽  
Medical College ◽  
Meconium Stained Amniotic Fluid

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.

scholarly journals Study of risk factors and perinatal outcome in meconium stained deliveries from a district of Uttar Pradesh, India

2018 ◽  
Vol 7 (9) ◽  
pp. 3605
Author(s):  
Richa Rathoria ◽  
Ekansh Rathoria ◽  
Utkarsh Bansal ◽  
Madhulika Mishra ◽  
Ila Jalote ◽  
...  
Keyword(s):  
Risk Factors ◽  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Birth Asphyxia ◽  
Meconium Aspiration Syndrome ◽  
Pregnancy Induced Hypertension ◽  
Meconium Aspiration ◽  
Fetal Bradycardia ◽  
Induced Hypertension ◽  
Meconium Stained Amniotic Fluid

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.

scholarly journals Effect of Meconium Stained Amniotic Fluid on The Risk of Infants Asphyxia: A Meta-Analysis

2020 ◽  
Author(s):  
Alfiati Nanda Widiyaningrum ◽  
◽  
Bhisma Murti ◽  
Eti Poncorini Pamungkasari ◽  
◽  
...  
Keyword(s):  
Amniotic Fluid ◽  
English Language ◽  
Meta Analysis ◽  
Birth Asphyxia ◽  
Fixed Effect Model ◽  
Meconium Aspiration Syndrome ◽  
High Morbidity ◽  
Cross Sectional ◽  
Meconium Aspiration ◽  
Meconium Stained Amniotic Fluid

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

Approach to Infants Born Through Meconium Stained Amniotic Fluid: Evolution Based on Evidence?

2018 ◽  
Vol 35 (09) ◽  
pp. 815-822 ◽  
Author(s):  
Sushma Nangia ◽  
Praveen Chandrasekharan ◽  
Satyan Lakshminrusimha ◽  
Munmun Rawat
Keyword(s):  
Amniotic Fluid ◽  
Neonatal Intensive Care ◽  
Positive Pressure Ventilation ◽  
Neonatal Resuscitation ◽  
Meconium Aspiration Syndrome ◽  
Positive Pressure ◽  
Randomized Controlled Studies ◽  
Randomized Control ◽  
Meconium Stained Amniotic Fluid ◽  
Ischemic Encephalopathy

AbstractMeconium-stained amniotic fluid (MSAF) during delivery is a marker of fetal stress. Neonates born through MSAF often need resuscitation and are at risk of meconium aspiration syndrome (MAS), air leaks, hypoxic-ischemic encephalopathy, extracorporeal membrane oxygenation (ECMO), and death. The neonatal resuscitation approach to MSAF has evolved over the last three decades. Previously, nonvigorous neonates soon after delivery were suctioned under the vocal cords with direct visualization technique using a meconium aspirator. The recent neonatal resuscitation program (NRP) recommends against suctioning but favors resuscitation with positive pressure ventilation of nonvigorous neonates with MSAF. This recommendation is aimed to prevent delay in resuscitation and minimize hypoxia-ischemia often associated with MSAF. In this review, we discuss the pathophysiology, evolution and the evidence, randomized control trials, observational studies, and translational research to support these recommendations. The frequency of ECMO use for neonatal respiratory indication of MAS has declined over the years probably secondary to improvements in neonatal intensive care and reduction of postmaturity. Changes in resuscitation practices may have contributed to reduced incidence and severity of MAS. Larger randomized controlled studies are needed among nonvigorous infants with MSAF. However, ethical dilemmas and loss of equipoise pose a challenge to conduct such studies.

scholarly journals Clinical profile of meconium aspiration syndrome in relation to birth weight and gestational age

2018 ◽  
Vol 5 (3) ◽  
pp. 726
Author(s):  
Ravi Garg ◽  
Rupesh Masand ◽  
Chaman Ram Verma ◽  
Girdhari Lal Sharma ◽  
Suman Ankit Yadav
Keyword(s):  
Risk Factors ◽  
Birth Weight ◽  
Gestational Age ◽  
Birth Asphyxia ◽  
Meconium Aspiration Syndrome ◽  
P Value ◽  
Maternal Risk Factors ◽  
Meconium Aspiration ◽  
Maternal Risk ◽  
The Mean

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.

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 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 Pattern and outcome of admissions in a neonatal high dependency unit of a medical college hospital in Khulna, Bangladesh

Mediscope ◽  
2018 ◽  
Vol 5 (2) ◽  
pp. 1-7
Author(s):  
MB Ali ◽  
AA Maruf ◽  
MM Rashid
Keyword(s):  
Neonatal Jaundice ◽  
Tertiary Care ◽  
Birth Asphyxia ◽  
Medical College Hospital ◽  
High Dependency Unit ◽  
College Hospital ◽  
Meconium Aspiration ◽  
Medical College ◽  
High Dependency ◽  
Time Of Admission

To determine the pattern and outcome of admitted patients in neonatal high dependency unit of a medical college hospital in Khulna, Bangladesh the patients in this study were included from January 2016 to December 2016. Data of all the neonatal admissions were recorded and analyzed for age, gender, weight at the time of admission, place of delivery, the reason for admission, duration of hospital stay and the final outcome of the patients. A total of 433 neonates were admitted during the year 2016. Among them, 262 (60.5%) were male and 171 (39.5%) female patients. Majority of the newborns, 255 (58.9%), were admitted within 24 hours of life. Most of the patients, 365 (84.3%), were born in hospitals/ private clinics and the others, 68 (15.7%), at home. Major causes of admissions were sepsis 115 (26.6%), neonatal jaundice 102 (23.6%), low birth weight (LBW) 61 (14.1%), birth asphyxia 48 (11.1%), preterm 27 (6.2%), meconium aspiration 22 (5.1%), respiratory distress syndrome (RDS) 19 (4.4%) and intrauterine growth retardation 18 (4.2%). Most of the patients, 215 (49.7%), were admitted for 2-5 days followed by 118 (27.3) patients for 6-10 days. Three hundred seventy (85.4%) babies were discharged after improvement, 18 (4.2%) babies referred to higher centers, 20 (4.6%) discharged against medical advice and 25 (5.8%) deceased. The deceased were most frequently with neonatal sepsis 9 (36.0%) followed by prematurity 6 (24.0%), birth asphyxia 3 (12.0%), RDS 2 (8.0%), meconium aspiration 3 (12.0%) and multiple congenital anomalies 2 (8.0%). Sepsis, neonatal jaundice, LBW, birth asphyxia were the main causes of neonatal admissions. Common causes of neonatal mortality were sepsis, prematurity and birth asphyxia. The majority of morbidities and subsequently the mortalities can be prevented by improving antenatal care, maternal health, timely intervention, referring at an appropriate time to tertiary care centers.Mediscope Vol. 5, No. 2: Jul 2018, Page 1-7

scholarly journals Maternal Risk Factors Associated With Autistic Children

2014 ◽  
Vol 5 (2) ◽  
pp. 14-17 ◽  
Author(s):  
S Riya ◽  
M Begum ◽  
N Begum ◽  
F Majid ◽  
S Jahan ◽  
...  
Keyword(s):  
Birth Asphyxia ◽  
Maternal Risk Factors ◽  
Autistic Children ◽  
Special Schools ◽  
Obstructed Labor ◽  
Maternal Risk ◽  
Factors Associated ◽  
Medical College ◽  
Threatened Abortion ◽  
Postnatal Factors

The present study has been carried out to find out the distribution of prenatal, perinatal and postnatal factors associated with autistic children. The study was conducted on 270 autistic children with age ranges of 3-10 years attending special schools in Dhaka city exclusively for autistic children during July ,2001 to July ,2012 .Mean age of mother was 31.78 SD± 5.94 years .Socio demographic characteristics showed 84% housewives, 37% educated up to masters level. Mean family monthly income was Tk.24,596 SD±11,464.Antenatal factors showed 42.2% mothers anemic,44.4% had H/O pre eclampsia,40% threatened abortion, 38.1% had gestational diabetes. Perinatal factors showed obstructed labor to be 64.4%.Post natal factors showed birth asphyxia to be 47.0% and neonatal jaundice 72.6% . The study showed a higher maternal age is significantly associated with autism.(p=0.007, RR=1.18,95% CI, 0.87- 1.60) and birth asphyxia is strongly associated with autism (p=0.001,OR=8.86 , 95% CI, 1.91-41.04) .The increasing prevalence of ASD`s indicates that it is multifactorial in which genetic, prenatal, social, developmental, nutritional and environmental factors play major roles. DOI: http://dx.doi.org/10.3329/akmmcj.v5i2.21126 Anwer Khan Modern Medical College Journal Vol. 5, No. 2: July 2014, Pages 14-17

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