Perinatal outcome in relation to mode of delivery in meconium stained amniotic fluid
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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.Keywords:
Meconium aspiration syndrome
Apgar score
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.
Meconium aspiration syndrome
Apgar score
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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.
Meconium aspiration syndrome
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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: 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.
Meconium aspiration syndrome
Rupture of membranes
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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.
Meconium aspiration syndrome
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Abstract
Background: Approximately 15% of all live births are complicated by meconium-stained amniotic fluid. Fortunately, only 5% of neonate born through meconium staining amniotic fluid (MSAF) develop meconium aspiration syndrome (MAS). This study was designed to assess the frequency of meconium staining amniotic fluid, meconium aspiration syndrome and their associated factors.
Methods: this cross-sectional study performed during 2004-2005 in Alghadir hospital, which is a charity hospital located in the east part of Tehran with a large number of deliveries annually and also a highly equipped neonatal ICU. All live births newborns in these 2 years included in the study and newborns with MSAF and MAS were evaluated more.
Findings: There were 6355 live births in the hospital in this period. Two hundreds and nineteen (3.4%) of them had MSAF and MAS developed in only 12 newborns (0.002 of total births and 5% of MSAF). In MAS group, 7 neonates (58.3%) had low APGAR score ( 0.05).
Conclusion: There are meaningful relationships between MAS with low APGAR and thick meconium.
Keywords: Amniotic fluid, Apgar score, Meconium, Meconium aspiration syndrome
Meconium aspiration syndrome
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Background: Meconium-stained amniotic fluid is a major reason for concern for both obstetricians and pediatricians since it raises the risk of birth hypoxia, maternal-asphyxia syndrome, and hospitalizations to the neonatal intensive care unit. Objective: To find the frequency of meconium stained liquor in females presenting in labor at term and to compare the frequency of adverse feto-maternal outcome with or without meconium stained liquor in females presenting in labor at term. Materials & Methods Study Design: Descriptive study SETTING: Department of Obstetrics & Gynecology, Fatima Memorial Hospital Lahore Duration: Six months i.e. 15-12-2020 to 15-6-2021 Data Collection Procedure: A total of 175 females fulfilled the inclusion criteria were included. Then females were followed up in labor room. If meconium stained liquor was observed, then it was noted and female were divided in two groups i.e. with meconium stained liquor and without meconium stained liquor. Mode of delivery was noted. Apgar score was noted and labeled as poor if <7 at 5 minutes. Birth asphyxia and need for NICU admission was noted. Than all these patients were followed up in gynecology wards for 3 days, neonatal mortality was noted, if occurred. Results: In this study frequency of meconium stained liquor in females presenting in labor at term was 51(29.1%). Comparison of feto-maternal outcome in women with and without meconium stained liquor showed that C-section rate (37.3% vs. 18.5%, p-value=0.008), Poor Apgar score (7.8% vs. 1.6%, p-value=0.040), NICU admission (13.7% vs. 3.2%, p-value=0.009), Birth Asphyxia (19.6% vs. 4%, p-value=0.001) and early neonatal mortality (13.7% vs. 3.2%, p-value=0.009) was significantly higher among women with meconium stained liquor. Conclusion: Keeping in mind the results of this study it can be concluded that positive meconium stained liquor had a significantly impact on maternal as well as neonatal outcome. Keywords: Meconium, Stained liquor, C-section, Birth Asphyxia, NICU, Mortality
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The studied material comprised 36 newborns and their mothers, among them 12 newborns had meconium in the amniotic fluid (study group) and 24 newborns with clear amniotic fluid served as controls. The fluids were studied biochemically. In both compared groups the analysed factors were: 1) week of labour, 2) body weight and length, 3) clinical condition of the newborn by the Apgar score, 4) type of labour, 5) type of pregnancy complications in mothers. The results were subjected to statistical analysis. It was found that meconium presence in the amniotic fluid correlated with the presence of clinical symptoms suggesting intrauterine asphyxia of the fetus, and the number of caesarean sections was greater in this group. A correlation was noted between the presence of meconium in the amniotic fluid and worse clinical condition of the newborn.
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OBJECTIVES This study aimed to find out the risk factors leading to meconium aspiration syndrome in patients having meconium-stained amniotic fluid. METHODOLOGY This comparative study was conducted in the department of Obstetrics and Gynaecology at Hayatabad Medical Complex from January 2022- June 2022. All patients admitted to the labour ward with the diagnosis of meconium-stained liquor (MSL) were included in the study through a convenient sampling technique. Patients were divided into two groups, group 1 having only meconium-stained amniotic fluid (MSAF) without meconium aspiration syndrome while group 2 having babies with the diagnosis of meconium aspiration syndrome (MAS). Both groups were compared for different risk factors for the development of MAS. Differences in the risk factors between the two groups were analyzed using Pearson’s correlation with a p-value of <0.05 considered significant. SPSS vs 20 was used for statistical analysis. RESULTS 84 patients were included in the study, i.e., 61 in group 1 and 23 in group 2. The mean age of the patients was 25± 3.45. The frequency of meconium-stained amniotic fluid was 3.83%. Meconium aspiration syndrome developed in 23 babies out of 84 MSAF deliveries (27.38%). Low APGAR score (< 0.00), patients handled outside the hospital (<0.001) and prolonged second stage (0.003) were significant risk factors for the development of MAS. CONCLUSION In the prolonged second stage, patients handled outside the hospital by unauthorized personnel and low APGAR score at birth were statistically significant risk factors for developing meconium aspiration syndrome.
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