Fetal Outcome in Meconium Stained Deliveries

Mundhra, Rajlaxmi; Mb, Agarwal

doi:10.7860/jcdr/2013/6509.3781

Cited by 74 publications

(101 citation statements)

References 7 publications

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“…16 Regarding mode of delivery, most studies have found a higher caesarean section rate. 1,5,11 Shaikh EM found it was not uncommon for obstetricians to be more aggressive in labors with meconium stained amniotic fluid leading to higher caesarean section rate, which was 82% in their study. 17 In contrast the caesarean section rate in the clear liquor group was 18% (82% vs 18% P<0.05).…”

Section: Discussionmentioning

confidence: 93%

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Fetal heart rate patterns in patients with thick meconium staining of amniotic fluid and its association with perinatal outcome

Desai

Maitra

Patel

2017

Int J Reprod Contracept Obstet Gynecol

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Background: This study assesses the role of abnormal fetal heart rate tracing patterns in patients with thick meconium staining of the amniotic fluid and its association with perinatal outcomes.Methods: Prospective unmatched case-control study on 2 groups of 136 subjects each- cases had thick MSAF and controls had clear liquor with abnormal fetal heart rate tracings on cardiotocography.Results: Gestational age (GA) >40 weeks, was found to have a significant association with MSAF (p value 0.01556 CI 95%). Premature Rupture of membranes at term (PROM) showed a significant association with MSAF with an OR of 2.25 (95% CI 1.37, 3.7); Post datism had significantly higher odds for being a risk factor for MSAF with an OR (3.194) (CI 95% 1.003-10.165). MSAF was not found to be significantly associated with abnormal trace on CTG. Neonatal morbidity (MAS, birth asphyxia, sepsis, HIE) had statistically higher odds in cases 1.669 (0.884-3.150) as compared to controls.Conclusions: No particular cardio-tocograph pattern can be considered to have a poor prognostic value in the presence of thick MSAF and the decision to deliver and the mode of delivery should be based on the overall assessment and the stage and progress of labor. While management should be individualized, a higher Caesarean section rate in thick MSAF can be justified to ensure a better outcome for the neonate even in the presence of a normal CTG trace.

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Section: Discussionmentioning

confidence: 93%

“…Sample size was calculated using Epi-Info software, and using NICU admission rate as outcome to be studied in cases and controls. 1 Fetal heart rate abnormalities were documented as per current recommendations. 6 Cases and controls were selected on the basis of following inclusion criteria.…”

Section: Methodsmentioning

confidence: 99%

Fetal heart rate patterns in patients with thick meconium staining of amniotic fluid and its association with perinatal outcome

Desai

Maitra

Patel

2017

Int J Reprod Contracept Obstet Gynecol

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“…Factors such as placental insufficiency, maternal hypertension, pre-eclampsia, oligohydramnios or maternal drug abuse (tobacco, cocaine) result in In utero passage of meconium. [3] so theexistence of MSAF in other circumstances is a marker of fetal distress and may be associated with adverse fetal and neonatal outcome [4,5] . The strong relationship of stillborn infants, abnormal FHR tracings, neonatal encephalopathy, respiratory distress (Meconium aspiration syndrome, MAS) and abnormal neurological outcome with presence of MSAF has been testified in the literature.…”

Section: Introductionmentioning

confidence: 99%

Meconium Stained Liquor, An Obstetrician’s Dilemma- A Clinical Study of Fetomaternal Outcome

Singh¹

2018

jmscr

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“…8,9 Other studies have found incidence rate as low as 3.03% to as high as 18%. 1,2,10,11 This probably reflects the level of antenatal care in different places where these studies were conducted.…”

Section: Discussionmentioning

confidence: 99%

“…1 The passage of meconium may simply represent the normal physiological in-utero gastrointestinal maturation process or it may indicate an acute or chronic hypoxic event, thus making it a warning sign of fetal compromise. 2 Meconium aspiration syndrome (MAS) may be defined as a respiratory distress which develops shortly after birth with radiographic evidence of aspiration pneumonitis in the presence of meconium stained amniotic fluid(MSAF). 3,4 In addition to it, the rate of severe mental retardation and cerebral palsy is significantly higher among surviving infants born with MAS.…”

Section: Introductionmentioning

confidence: 99%

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

Garg¹,

Masand²,

Verma³

et al. 2018

Int J Contemp Pediatr

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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.

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Fetal Outcome in Meconium Stained Deliveries

Abstract: Meconium stained amniotic fluid is really worrisome from both, obstetrician's and paediatrician's points of view, as it increases the caesarean rates, causes birth asphyxia, MAS and increases neonatal intensive care unit admissions.

Cited by 74 publications

References 7 publications

Fetal heart rate patterns in patients with thick meconium staining of amniotic fluid and its association with perinatal outcome

Fetal heart rate patterns in patients with thick meconium staining of amniotic fluid and its association with perinatal outcome

Meconium Stained Liquor, An Obstetrician’s Dilemma- A Clinical Study of Fetomaternal Outcome

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

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