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

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

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Clinical study of babies born through meconium stained amniotic fluid

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20190687 ◽

2019 ◽

Vol 6 (2) ◽

pp. 491 ◽

Cited By ~ 1

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.

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

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20205443 ◽

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.

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Perinatal Outcome Associated with Meconium Stained Amniotic Fluid In Pregnancy

Journal of Paediatric Surgeons of Bangladesh ◽

10.3329/jpsb.v4i2.23937 ◽

2015 ◽

Vol 4 (2) ◽

pp. 44-49 ◽

Cited By ~ 1

Author(s):

Nasrin Begum ◽

Sharmeen Mahmood ◽

Salma Akhter Munmun ◽

MS Haque ◽

KN Nahar ◽

...

Keyword(s):

Birth Weight ◽

Amniotic Fluid ◽

Apgar Score ◽

Perinatal Outcome ◽

Perinatal Death ◽

Mode Of Delivery ◽

Neonatal Resuscitation ◽

Meconium Aspiration Syndrome ◽

Meconium Aspiration ◽

Meconium Stained Amniotic Fluid

Objectives: To evaluate perinatal outcome associated with meconium stained amniotic fluid in pregnant women.Methods: It was a prospective cross sectional study, conducted in the Department of Obstetrics and Gynecology in Bangabandhu Sheikh Mujib Medical University, Dhaka, from January 2013 to December 2013. Total 50 pregnant women admitted in the labour ward for delivery with meconium stained amniotic fluid were the study population. Singleton pregnancy of more than 34 weeks duration was included and pregnancy with APH, breech presentation, congenital malformation of fetus, IUD were excluded from the study. Out of 50 patients two did not provide all the information needed to analyze the data and hence were excluded. Outcome Variables were gestational age, antenatal checkup, medical diseases of mother (HTN, Diabetes mellitus, Heart disease), obstetric complication (oligohydramnios, prolonged labour), mode of delivery, neonatal details (weight of the baby in kg, APGAR scoring at 1 min & 5 min), neonatal resuscitation, admission in neonatal ICU(NICU), neonatal complications (RDS, MAS, Neonatal death).Results: Over half (52.1%) of the neonates needed resuscitation and 54.2% admitted in ICU. About 90% of the neonates had normal birth weight and only 10.4% were of low birth weight. 14.6% of the neonates developed meconium aspiration syndrome and 10.4% respiratory distress syndrome. Neonatal jaundice and neonatal sepsis were observed in 4.2% neonates each. Four neonates (8.3%) died early in the neonatal life, while 1 (2.1 %) was still-born. Low APGAR score (<7) at 1 and 5 minutes of birth was found in 64.7% and 52.9% of the cases respectively with thick meconium stained amniotic fluid as opposed to 25.8% and 16.1% of the cases respectively having thin meconium stained amniotic fluid (p = 0.008 and p = 0.007 respectively). Thick meconium was significantly associated with meconium aspiration syndrome (p = 0.003). Neonates needing immediate resuscitation and admission in ICU was staggeringly higher in the former group than those in the later group (p = 0.002). The incidence of perinatal death was significantly higher in patients with thick meconium stained amniotic fluid than that in patients with thin meconium ( p= 0.021).Conclusion: Meconium stained amniotic fluid was associated with low APGAR score, higher incidence of MAS, ICU admission and perinatal death.J. Paediatr. Surg. Bangladesh 4(2): 44-49, 2013 (July)

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Study of Maternal and Fetal Outcome in Pregnancy with Heart Disease

Anwer Khan Modern Medical College Journal ◽

10.3329/akmmcj.v8i2.33666 ◽

2017 ◽

Vol 8 (2) ◽

pp. 112-116 ◽

Cited By ~ 2

Author(s):

Sharmin Abbasi ◽

Sehereen Farhad Siddiqua ◽

Shifin Rijvi ◽

Salma Akhtar ◽

Benozir Haque ◽

...

Keyword(s):

Heart Disease ◽

Cardiac Disease ◽

Nyha Class ◽

Mode Of Delivery ◽

Fetal Outcome ◽

Functional Class ◽

Maternal Complications ◽

College Hospital ◽

Medical College ◽

In Pregnancy

Background: Heart disease complicating pregnancy is an important indirect cause of maternal mortality and morbidity. Maternal heart disease comprises .2%-2% of pregnancies and responsible for 10%-20% of maternal deaths1. Our study was done to evaluate fetomaternal outcomes in pregnancy with heart disease.Objectives: Evaluation of fetomaternal outcome in pregnant patients with cardiac disease. Materials andMethods: This observational study was done in Bangabandhu Sheikh Mujib Medical University and Anwer Khan Modern Medical College Hospital among 51 pregnant women with known or newly diagnosed heart disease from January 2013-january 2015. Baseline data recorded demographic character, NYHA functional class, maternal complications, mode of delivery and neonatal outcome.Results: Among 51 cardiac patients, 32 (63%) were primigravida. Mostly 46 (90.6%) belonging to NYHA Class I and II. Rheumatic heart disease seen in 45 (87%) and congenital heart disease in 10% subjects. Mitral stenosis was the most common, seen in 22 (41%) cases. 47.33% patients were delivered vaginally and LSCS done in 41% patients. The fetal outcome were live births in (96.6%) cases, (27.4%) babies required NICU admission.Conclusion: An improvement in modern techniques of monitoring, better understanding of pathophysiology of cardiac disease and multi disciplinary care can lead to substantial improvement in the feto maternal outcome.Anwer Khan Modern Medical College Journal Vol. 8, No. 2: Jul 2017, P 112-116

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

Mediscope ◽

10.3329/mediscope.v6i2.43155 ◽

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

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Management and Outcome of Postdated Pregnancy at Rajshahi Medical College Hospital

TAJ Journal of Teachers Association ◽

10.3329/taj.v31i2.41597 ◽

2019 ◽

Vol 31 (2) ◽

pp. 50-53

Author(s):

Most Merina Akhter ◽

Mst Shaheen Nawrozy ◽

Abu Hena Mostafa Kamal ◽

Sahela Jesmin

Keyword(s):

Perinatal Mortality ◽

Mode Of Delivery ◽

Birth Asphyxia ◽

Fetal Distress ◽

Fetal Outcome ◽

Medical College Hospital ◽

Maternal Complications ◽

College Hospital ◽

Mortality And Morbidity ◽

Medical College

Background: Postdated pregnancy complicates about 10% of all gestation and is associated with an increase in perinatal mortality and morbidity. This study was designed to observe fetal as well as maternal outcome in the management of postdated pregnancies admitted into Rajshahi Medical College Hospital. Methods: The study was carried out from July 2008 to June 2010. 100 cases of postdated pregnancies were included. Patients’ age, occupation, parity, mode of delivery, the indication of LUCS, fetal & maternal outcomes were recorded in a predesigned questionnaire. Results were expressed as Mean± SD, actual number and percentage of total where applicable. Results: Mean age (±SD) was 21.3 (±5.32) years. 90% were housewives, 5% were in service and 5% were in other occupations. 53% were nullipara, 21% para-2, 18% were para-3, 8% were para-4.57% of the study patients underwent caesarean section and 43% underwent vaginal delivery. Fetal distress (n=34), non-progression of labour (n=19), cord prolapse (n=1) & CPD (n=3) were the causes of LUCS. Regarding fetal outcome, healthy babies were 76%, meconium aspiration 13%, birth asphyxia 11%. Among birth asphyxia, neonatal death was 1% & still born was 2%. Maternal complications at delivery were tear in the genital tract 8%, PPH 5% & wound infection in 4% cases. Conclusion: Here, still-birth rate was 2% (normally about 1 in 3000 deliveries) and perinatal mortality rate is 3% (normally about 2-3 in 1000 deliveries). So, patients should be encouraged to attend regular antenatal check up to prevent postdated pregnancy and its complications. TAJ 2018; 31(2): 50-53

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

Health Renaissance ◽

10.3126/hren.v10i3.7135 ◽

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

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Study of maternal and fetal outcome in antepartum eclampsia in a tertiary care hospital

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20180902 ◽

2018 ◽

Vol 7 (3) ◽

pp. 1108

Author(s):

Aruna Rani R. ◽

Dheeba Jayanthi R. ◽

Eswari S.

Keyword(s):

Gestational Age ◽

Tertiary Care ◽

Mode Of Delivery ◽

Fetal Outcome ◽

Care Hospital ◽

College Hospital ◽

Medical College ◽

Obstetric Emergencies ◽

One Year ◽

A Prospective Study

Background: In modern obstetrics, the prevalence of Eclampsia and its complications are high, so we decided to study pregnancy outcome in all Antepartum Eclampsia patients. The present study was carried out to investigate the maternal and fetal outcome in patient with Antepartum eclampsia.Methods: A prospective study was conducted in Government Mohan Kumaramangalam Medical College Hospital, Salem, India over a period of one year from January 2016 to December 2016 in all Antepartum Eclampsia patients. Analysis was done regarding the age of women, parity, gestational age, imminent symptoms, mode of delivery, fetal outcome and maternal morbidity and mortality.Results: Incidence of Antepartum Eclampsia in our hospital is 0.7%. It is more common in age group of 20 to 25years (68.5%) and primigravida (56%) and gestational age >37 weeks (51.85%). Commonest mode of delivery was by caesarean section (72%). Out of 54 patients of Antepartum Eclampsia 3 (5.5%) died and 18 (33%) had complications. Out of 50 live babies, 16 (32%) died.Conclusions: Eclampsia is still one of the important and common obstetric emergencies and it has a significant role in maternal and fetal outcome. The early identification of risk factors and timely intervention is needed to improve maternal and perinatal outcome.

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Immediate clinical outcome of newborns with meconium stained amniotic fluid

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20183514 ◽

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.

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