Meconium-stained liquor and its impact on maternal and neonatal outcome
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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.Keywords:
Meconium aspiration syndrome
Apgar score
Cardiotocography
Background: Meconium stained amniotic fluid is the movement of meconium in the uterus by the fetus during the ANC period or through labor. It has been speculated during the intrapartum and postpartum period as a factor affecting fetal wellbeing and considered as the hallmark symptom of imminent asphyxia. Aim and objectives of current study were to correlate the presence of meconium-stained amniotic fluid with the mode of delivery and perinatal outcome.Methods: A total of 100 women were taken in the study in which meconium stained amniotic fluid and its relation with mode of delivery and neonatal outcome were observed for 2 years.Results: A total of hundred cases were studied. Incidence of types of meconium found to be thin (25%), moderate (34%) and thick (41%). 76% of patients with thin meconium were delivered vaginally without any assistance with instruments, while 64.7% and 68.3% of cases with moderate to thick meconium respectively were delivered by LSCS. In the group of patients with APGAR score more than 7 at five minutes, there is more percentage of patients with thin MSL while in the group of patients with APGAR score less than 7, there is more percentage of patients with thick meconium. No cases of meconium aspiration syndrome were foundConclusions: The types of meconium affect the mode of delivery and fetal outcome. There is no association between having a low birth weight and passage of meconium during labor. The severity of the type of meconium associated with APGAR might be due to severe hypoxia and severe form of nervous system depression leading to cardiovascular and respiratory depression and activation of the parasympathetic nervous system causing anal sphincter relaxation and passage of meconium.
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Objective To investigate effect of the intrahepatic cholestasis of pregnancy(ICP) on perinatal prognosis.Methods 145 cases of ICP pregnant women giving birth in hospital between October 2009 and March 2011 were taken as ICP group.Another 145 cases of cases of normal pregnant women during the same period were taken as control group for comparisons between fetal distress,meconium-stained amniotic fluid,neonatal asphyxia,preterm children,neonatal pneumonia,and the incidence of perinatal death.Results The differences of fetal distress,meconium-stained amniotic fluid,neonatal asphyxia,and the incidence of neonatal pneumonia between ICP group and the control group were significant(P0.05).Conclusion ICP can lead to fetal distress,meconium-stained amniotic fluid,neonatal asphyxia and premature birth.Early detection,diagnosis,treatment and timely termination of pregnancy can reduce perinatal mortality.
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Background: To identify the frequency of meconium aspiration syndrome among the total births who suffered from meconium staining of amniotic fluid, to find out risk factors during pregnancy, therapies and various complications associated with this condition and their effects on perinatal outcome.Methods: This was a retrospective study of 252 antenatal patients delivered at Department of DNB-OBG District hospital Bellary during the year January 2019 to December 2019 with gestational age between 37-40 weeks with singleton pregnancies and cephalic presentation were included in the study.Results: The Caesarean section rate for fetal distress was 96.6% in patients with meconium stained amniotic fluid (MSAF). Meconium aspiration syndrome (MAS) was found in3.93% babies. APGAR score at 1 minute <7 was found in 25 cases (9.84%).Conclusions: Meconium stained amniotic fluid is associated with increased need for neonatal resuscitation, increased risk of birth asphyxia, meconium aspiration syndrome, hospital admission and mortality. So identification of pregnant woman at risk of passage of meconium during labour would allow intensive fetal surveillance and early intervention which might lead to reduction in neonatal adverse outcome.
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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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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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Background: Meconium stained amniotic fluid has been considered a sign of fetal distress in presentations other than breech and associated with poor fetal outcome but others considered meconium passage by fetus as physiological phenomenon and produces environmental hazards to fetus before birth. Such magnitude of different opinion was the object behind taking up of this study. Aims and objectives: To study maternal risk factors responsible for meconium stained amniotic fluid and its correlation with the fetal outcome in terms of morbidity and mortality. Meterial and methods: 100 women in labour with meconium stained amniotic fluid studied considering the inclusion criteria in the Department of Obstetrics and Gynecology, Pravara Rural Hospital, Loni. Cases divided into two -‘thin’ and ‘thick’ meconium stained group. Maternal and Fetal monitoring, uterine contraction assessed and Apgar score, birth weight, resuscitation of baby noted. All babies of both group followed up to first week neonatal life. Results: In our study, among 100 cases, 45% of the cases had thin meconium and 55% had thick meconium. Increased incidence of meconium staining was seen in crossed dates. The other risk factors were hypertension, anemia, oligohydramnios, IUGR. 56% went in for cesarean section due to intrapartum fetal distress. 33% of the cases went into NICU in view of low APGAR score due to birth asphyxia and meconium aspiration syndrome. Perinatal death was seen in 4 cases, one due to birth asphyxia and the other three due to MAS. Conclusion: Based on this study we conclude that meconium stained amniotic fluid is associated with increased incidence of caesarean section, low APGAR score, meconium aspiration syndrome and increased NICU admission.
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Background: Meconium staining of the amniotic fluid is a common problem occurring in 10-22% of all deliveries. Meconium aspiration syndrome complicates approximately 1.5% of these deliveries with a reported mortality rate as high as 40%. Objectives of the study were to determine whether meconium stained liquor during labour is associated with fetal distress and to check if there is any correlation in between the degree of meconium staining liquor and fetal outcome.Methods: A clinical study of 200 cases of meconium stained amniotic fluid in cephalic presentation was undertaken among patients who were admitted in labour room were examined in detail and investigations were done. Fetal heart rate and its pattern were noted every fifteen min. Total APGAR score at one minute and five minute was noted down. Odds ratio with 95% confidence interval was calculated. Proportions were analyzed using chi square value.Results: Majority of the study subjects belonged to the age group of 21-30 years. Majority i.e. 54.5% were multigravida. Majority had toxemia in 24% of the cases. Fetal distress and the incidence of forceps delivery or LSCS was significantly more in those with thick meconium compared to those with thin meconium (p<0.05). But fetal asphyxia was not associated with type of stained meconium. It is seen that as the duration of the meconium staining increased, the proportion of babies with low APGAR score, perinatal mortality and morbidity increased.Conclusions: Thick meconium stained amniotic fluid was associated with increased rate of interventions, neonatal morbidity and mortality compared to thin meconium stained meconium fluid.
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Background: Meconium staining amniotic fluid is associated with lots of adverse outcome and has long been considered to be a bad predictor of fetal outcome. This prospective observational study was undertaken to find out immediate fetal outcome in meconium-stained liquor.Methods: The design of the study was prospective. This study was conducted from July 2021 to December 2021.The study included women with meconium-stained amniotic fluid in labor with gestational age >37 completed weeks.Results: Total 100 cases were enrolled. Majority of the patients (74%) were in the age group of 21-30 years with the mean age being 24.6±2.4 years. Fetal distress occurred in 30% of babies, more in association with thick meconium (15%). Caesarean deliveries were 70%. Apgar scores between 0-3 was seen in 17% babies and 1% at fifth minute, between 4-6 in 21% babies and between 7-10 in 62% babies at first minute of birth. Admission in neonatal ward was 32% with perinatal mortality of 6%.Conclusions: Meconium-stained amniotic fluid was associated with higher rate of caesarean delivery, increased need for neonatal resuscitation, increased rate of birth asphyxia with hypoxic ischemic encephalopathy, meconium aspiration syndrome, hospital admission and mortality. It is more commonly associated with pregnancy induced hypertension (PIH), post-datism, oligohydramnios and gestational diabetes mellitus.
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Background and Objectives: Meconium stained amniotic fluid has been considered a sign of fetal distress in presentations other than breech and associated with poor fetal outcome but others considered meconium passage by fetus as physiological phenomenon and produces environmental hazards to fetus before birth.
Such magnitude of different opinion was the object behind taking up of this study and aim of it was to find out the maternal risk factors associated and its correlation with the fetal outcome in terms of morbidity and mortality.
Methods: 100 women in labour with meconium stained amniotic fluid studied considering the inclusion criteria in the Department of Obstetrics and Gynecology, Konaseema Institute of Medical Sciences and Research Center, Amalapuram. Cases divided into two -‘thin’ and ‘thick’ meconium stained group. Maternal and Fetal monitoring, uterine contraction assessed and Apgar score, birth weight, resuscitation of baby noted. All babies of both group followed up to first week neonatal life.
Results: In our study, among 100 cases, 45% of the cases had thin meconium and 55% had thick meconium. Increased incidence of meconium staining was seen in crossed dates. The other risk factors were hypertension, anemia, oligohydramnios, IUGR. 56% went in for cesarean section due to intrapartumfetal distress. Perinatal death was seen in 4 cases, one due to birth asphyxia and the other three due to MAS.
Interpretation and Conclusion: Infants with meconium aspiration syndrome are to be managed in NICU for close monitoring and vigorous treatment. Co operation and coordination of the obstetrician and pediatrician is required to prevent the perinatal morbidity and mortality.
Based on this study we conclude that meconium stained amniotic fluid is associated with increased incidence of caesarean section, low APGAR score, meconium aspiration syndrome and increased NICU admission.
Keyword: Meconium, Amniotic fluid, Antepartum, Intrapartum, Neonate
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