Associated Factors and Outcome of Babies Born Through Meconium Stained Amniotic Fluid.
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Background Neonates born through meconium stained amniotic fluid (MSAF) are associated with significant morbidity and mortality. Objective To study the incidence, associated factors and outcome of meconium stained amniotic fluid babies born in Dhulikhel hospital. Method Prospective, cross-sectional study conducted in Obstetric ward and Neonatal Intensive Care Unit (NICU) from 15 December 2015 to 15 December 2016. All the babies born through meconium stained amniotic fluid during the period were included. Result Incidence of meconium stained amniotic fluid was 6.5%(167/2581). Meconium aspiration syndrome (MAS) developed in 9(5.4%) among all meconium stained amniotic fluid cases. Primigravidity and postdatism were observed more in Meconium aspiration syndrome group than meconium stained amniotic fluid group (77.8% VS 73.4%; 33.3% VS 26.3%). Babies delivered by caesarian section were more in meconium stained amniotic fluid group than Meconium aspiration syndrome group (47.5% VS 33.3%). All the babies with meconium stained amniotic fluid improved except one baby with Meconium aspiration syndrome who expired. Neonatal sepsis was a significant co-morbidity in Meconium aspiration syndrome group (P value= 0.008). There was increased incidence of operative delivery in thick meconium stained amniotic fluid than thin meconium stained amniotic fluid (52.6% VS 38.9%). Similarly, Neonatal Intensive Care Unit admission and neonatal complications like Meconium aspiration syndrome, perinatal asphyxia and sepsis were more commonly observed in thick meconium stained amniotic fluid group than thin meconium stained amniotic fluid group. Conclusion The progression to meconium aspiration syndrome in babies with meconium stained amniotic fluid is not associated with any maternal and neonatal factors studied. MAS babies are 10 times more likely to require NICU admission and sepsis is a significant co-morbidity. Thick meconium stained amniotic fluid is worrisome. There is increased chance of operative delivery and neonatal complications if associated with thick meconium stained amniotic fluid.Keywords:
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Backgrounds and objectives: Meconium -stained liquor could be an alarming sign of fetal distress and needs continuous fetal heart rate monitoring and urgent interventions. The study aimed to determine maternal and fetal outcomes among women presented with meconium-stained amniotic fluid during labor in relation to mode of delivery, rate of caesarian section, Admission to neonatal intensive care unit and neonatal complications and mortality. Methods: A cross-sectional study was carried out in Duhok Obestetric and Gynecology Teaching Hospital between 1st of September 2019 and 1st of April 2020 where 100 women in labor diagnosed with meconium stained amniotic fluid gestational age between (37_40+6 weeks) included in this study, all participants were meet inclusion criteria for this study and a written consent obtained from them. Results: The study showed that out of 100 participants with meconium stained liquor 48% of them delivered by lower segment cesarean section and the cause of 76.6% of them was fetal distress .The study showed significant statistical association between meconium stained liquor and lower mean scores of APGAR scores at 1 and 5 min , and rate of neonatal intensive care unit admission which was 74 (74.0%) and neonatal complications rate such as meconium Aspiration Syndrome (31.0%), Respiratory Distress Syndrome (14.0%), and Early Neonatal Death (3.0%) ,the study showed that women with spontaneous rupture membrane and thick meconium were significantly more likely to have infants with meconium aspiration syndrome; 46.2% and 48.1% respectively. Conclusions: This study showed that women in labor with meconium-stained amniotic fluid had higher fetal and maternal complications
Meconium aspiration syndrome
Apgar score
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Meconium aspiration syndrome
Polyhydramnios
Apgar score
Elective caesarean section
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Objective-The purpose of this study was to find out prevalence ,risk factors, mode of delivery, & perinatal out come in Meconium stained amniotic fluid (MSAF) during delivery At term pregnancy.Study design-this retrospective study was conducted in MGMC&RI,puducherry with womens at 37-42 wks of gestation those were meconium stained amniotic fluid during labour & delivery.Different maternal outcome like mode of delivery,indication for operative delivery & perinatal outcome in relation to low apgar score,neonatal intensive care unit( Nicu) admission,meconium aspiration syndrome(MAS),perinatal asphyxia & neonatal death were analysed .Result— Prevalence of meconium stained amniotic fluid during labour & delivery was 12.42% during study period.Most of the cases were primigravida (85%) with mean age & gestational age of-24.99 yrs & 39.44 wks respectively. Postdated pregnancy (32.85%) & oligo hydramnios(18.57%) were the two major risk factor for meconium stained amniotic fluid.Caesarean section (C.S) was the most common mode of delivery (84.28%) due to fetal distress & thick meconium stained liquor(40.71%).20% of cases were admitted to Nicu for low apgar score at birth.50% of nicu admission were due to MAS & its complication.There were two(7.14% of nicu admission) neonatal death due to MAS & its complication inspite of early active intervention in our study. Conclusion-Meconium stained amniotic fluid during labour & delivery is definite direct & indirect evidence of fetal distress(FD) .Grading of meconium stained amniotic fluid was a severe adverse effect in perinatal outcome. Instead of early active intervention there were early neonatal death in our study. So the outcome of meconium stained amniotic fluid during labour & delivery is unpredictable.
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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.
Meconium aspiration syndrome
Cephalic presentation
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BACKGROUND: Occurance of meconium-stained amniotic uid (MSAF) during labour may be considered as a measure for prediction of poor fetal outcomes such as meconium aspiration syndrome and perinatal asphyxia ,resulting in perinatal as well as neonatal morbidity and mortality. It constitutes about 5% of deliveries with meconium stained amniotic uid and death results in about 12% of infants with MAS. METHODS: 40 cases of meconium stained liquor detected after spontaneous or artical rupture of membranes taken during labour from june 2020 to december 2020 and their outcome in terms of mode of delivery(whether vaginal delivery or lower segment caesarean section) and fetal outcome and associated maternal high risk were studied RESULT: Anemia was co existant in around 15%, pregnancy induced hypertension(PIH) in 25%and premature rupture of membrane in 10%.Pregnancies complicated with Pregnancy induced hypertension had signicant higher rate of meconium stained liquor among all cases. Caesarean Section was commonly performed in meconium stained amniotic uid cases and accounted for about 65%of all cases. CONCLUSIONS: Meconium Stained amniotic uid increases the chances of caesarean rates,leading to birth asphyxia ,Meconium Aspiration Syndrome and hence increases the chances of neonatal intensive unit admission.
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Apgar score
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Background: To determine the perinatal outcome of with Meconium-stained amniotic fluid (MSAF) compared with clear amniotic fluid at Dhiraj Hospital.Methods: A prospective observational study was carried out in obstetrics and gynaecology department of Dhiraj Hospital, Sumandeep Vidyapeeth from March 2021 to August 2021. All patients fulfilling inclusion and exclusion criteria as mentioned above were taken for the study. All the categorial variables were analysed independently with the help of chi square test and fisher’s exact test and all the continuous variables were analysed with independent ‘t test’.Results: Out of 500 patients selected for the present study which had inclusion criteria, 13.6% were meconium stained out of which 50 (73.5%) cases had thin meconium and 18 (26.4%) cases had thick meconium. Fetal CTG abnormalities were more common in MSAF group and were noted in 38.2% of cases which is significantly increased compared to control group with CTG abnormalities in 8.3%. The difference was significant with p value of <0.001. 32(47.0%) patients with meconium-stained amniotic fluid had normal vaginal delivery, while in control group out of 432, 360 (83.3%) delivered normally. Incidence of LSCS and assisted vaginal delivery was more in meconium-stained amniotic fluid.Conclusions: Meconium-stained amniotic fluid is associated with more frequency of operative delivery, birth asphyxia, neonatal sepsis, and neonatal intensive care unit admissions compared to clear amniotic fluid. Better perinatal outcome in clear amniotic fluid compared to meconium stained liquor.
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Objective: To determine the different grades of meconium-stained liquor and association of fetal outcome (still birth, poor Apgar score, NICU admissions) among meconium-stained liquor patients according to their grades. Subject and Methods: This prospective case series study was conducted at the department of obstetrics and Gynaecology, civil Hospital Karachi, for 6 months from April 2019 to September 2019. After per vaginal examination meconium-stained amniotic liquor and grades of meconium-stained liquor were confirmed and these patients were monitored by auscultation of fetal heart sounds by pinard stethoscope and cardiotocography performed and when patients delivered, the frequency of fetal outcome according to grades noted and was documented on pre-designed proforma. Results: A total of 150 patient women were studied, their average age was 28.62±4.19 years and mean gestational age was 38.38+1.00 weeks. There 56% multiparous women. Of all meconium-stained liquor, grade II was commonest 40%, grade I 30% and grade III 30%. Still birth was 2.0%, poor Apgar score was 24.7% and rate of NICU admission was 28.0%. Maternal age, parity and gestational age effects were statistically significant on grade of liquor (p-<0.05). Conclusion: Meconium-stained liquor grade II was observed to be high. The adverse fetal outcomes in terms of still birth, low Apgar score and neonatal intensive care unit admission were observed to the significancy associated with meconium-stained liquor grades II and III. Meconium-stained amniotic fluid as a serious problem so early decision should be taken to improve the fetal outcome. Keywords: Meconium-stained amniotic fluid, still birth, poor Apgar score
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Meconium aspiration syndrome
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Background: Meconium stained amniotic fluid (MSAF) is predictor of adverse fetal outcomes. However, all fetuses with meconium passage do not have an adverse outcome and it is important to distinguish those who develop fetal distress promptly to prevent and intervene the sequalae accordingly. Hence this study was undertaken to study the grades of meconium stained liquor and its effect on intrapartum management and relation with maternal and neonatal outcome.Methods: A prospective observational study was conducted on term pregnancy patients. Firstly, the detailed case history and examination was performed. When membranes ruptured the colour of liquor was noted. Fetal monitoring by cardiotocography (CTG) was done continuously throughout labour. The mode of delivery, cord pH and base excess were noted. After the delivery Apgar score and weight of the baby, need for resuscitation, neonatal intensive care unit (NICU) admissions and neonatal complications were noted.Results: Of the 3117 deliveries conducted during the study period, 321 cases (10.29%) had meconium stained liquor out of whom, 183 women (57%) were with thin meconium and 138 (43%) had thick meconium. There was no risk factor identified in the majority of women. The CTG was reactive in most women with thin meconium (71.5%). There was a significantly higher incidence of pathological CTG’s in women with thick meconium (36.3%) (p value = 0.001). There was no significant difference in birth weight Apgar scores, cord pH, base excess in both the groups and rate of NICU admission.Conclusions: Maximum patients with thin meconium and reactive CTG included in our study delivered normally with good neonatal outcome. However presence of thick meconium in addition to other factors such as fetal heart rate alterations should be viewed seriously as it may pose a potential danger for the baby.
Meconium aspiration syndrome
Apgar score
Cardiotocography
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Introduction: Amniotic fluid index (AFI) is one of the parameter to assess fetal wellbeing. AFI is associated with perinatal morbidity and even mortality. Studies showing perinatal outcome of low AFI has not been done at Dhulikhel hospital so this study is conducted to find out the association of AFI with various adverse perinatal outcomes in pregnancies beyond 37 weeks.
Methods: This is a prospective, comparative study in the department of Obstetrics and Gynecology of Dhulikhel Hospital from December 2016 to May 2017. All the pregnant ladies at term pregnancy meeting the inclusion criteria were taken for the study. AFI was measured and the perinatal outcome was compared between two groups, i.e., AFI 8.
Result: Out of 1084 pregnant ladies, there were 94 ladies in with AFI<8cm. Most of the ladies in the study groups were primigravida with the mean age being 24.25 + 4.8 years. There were 62% cesarean section in group1, most common indication of cesarean section was fetal distress and meconium stain liquor. 29.8% of newborns were admitted in neonatal intensive care unit for meconium aspiration syndrome.10.6% of babies was born with low birth weight. There were two neonatal deaths in both groups due to hypoxic ischemic encephalopathy (HIE) - II.
Conclusion: AFI < 8 is associated with increased cesarean section deliveries for fetal distress and low birth weight babies.
Keywords :Amniotic Fluid Index, Meconium staining, Cesarean delivery, APGAR scores
Amniotic fluid index
Meconium aspiration syndrome
Apgar score
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