Incidence of and factors associated with meconium staining of the amniotic fluid in a Nigerian University Teaching Hospital

An, David; Njokanma, OF; Iroha, E O

doi:10.1080/01443610600797426

Cited by 36 publications

(43 citation statements)

References 9 publications

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“…17 David et al in their study reported that 48% were male and 52% female and was contradictory to the present study. 19 Eva Guachan et al in their study had M:F ratio of 1.8:1 which was in line with our study. 20 In a developing country like ours, such a vast difference based on sex can be attributed to the uneven male female ratio and it is historically proven that MSAF was more common in male babies.…”

supporting

confidence: 81%

Neonatal outcome in meconium stained amniotic fluid: a hospital based study

Singh¹,

Singh²,

Thapar³

2017

Int J Contemp Pediatr

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Background: Amniotic fluid surrounds the baby in utero and provides a protective and low resistance environment and acts as a cushion for the baby. It is secreted by amniotic membranes, foetal skin and fetal urine. The objectives of this study was to identify the incidence of meconium stained amniotic fluid, perinatal outcome and the risks during pregnancy leading to in utero passage of meconium.Methods: A prospective study conducted in Sri Guru Ram Das University, Amritsar, between 1st December 2014 to 1st June 2016. All live births with meconim stained amniotic fluid without congenital malformation, twin or multiple organ dysfunction were taken as subjects of this study. Maternal obstetric history and risk factors were asked and foetal parameters including gestational age, fetal presentation, mode of delivery, birth weight, sex, Apgar score, age at onset of respiratory distress, treatment and outcome were observed.Results: Out of 1121 admissions in NICU, 12% of inborn and 9.6% of outborn were with MSAF, out of which 34% developed MAS. Majority of neonates were observed to be males (73.6%), term neonates (67.2%), weight 2.5-3.5 kg (76.9%) with mean weight being 2.701 kg±0.558 kg and 16% mortality including 9 inborn and 11 outborn neonates. Mean age at onset of respiratory distress was 18.43 minutes±11.52 minutes. Neonatal outcome was significantly related to weight, APGAR score at 5 mins, and development of complications like MAS, hypoxic ischemic encephalopathy, necrotizing enterocolitis, acute renal failure and severe thrombocytopenia. Culture proven septicaemia was seen in 21.6% cases. Mean duration of stay in NICU was 6.48 days±0.54 days.Conclusions: MSAF has significant effect on perinatal outcome and close observation is required to prevent and treat complications thus reducing mortality.

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supporting

confidence: 81%

Neonatal outcome in meconium stained amniotic fluid: a hospital based study

Singh¹,

Singh²,

Thapar³

2017

Int J Contemp Pediatr

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“…8,9 In the studies done in India, the range of incidence varied from 7.4% to 14.3%. [10][11][12] In the present study, the incidence was 27% which is higher than reported in most of the literature.…”

Section: Discussioncontrasting

confidence: 54%

“…David et al found that fetal heart rate abnormality and low apgar was seen in MSAF group. 12 In spite of debate, there are still a number of unresolved controversies concerning management of the labour with meconium stained amniotic fluid. Nevertheless most obstetricians feel unsafe about the state of the fetus if meconium stained liquor is seen.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2012

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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.

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“…Although the precise etiology of MSAF is still unclear, risk factors for MSAF include advanced gestational age at delivery, mode of delivery, increased duration of rupture of membranes (ROM), prolonged second stage of labor, and intra-amniotic infection [8,9,15,17,20,21]. Recently, Cheng et al [20] demonstrated that the longer the duration of the second stage of labor, the higher the frequency of MSAF (21% when the second stage was less than 1 h, and 28% when it was longer than 3 h).…”

Section: Introductionmentioning

confidence: 99%

The frequency of meconium-stained amniotic fluid increases as a function of the duration of labor

Lee

Yang

et al. 2011

The Journal of Maternal-Fetal & Neonatal Medicine

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Objective The purpose of this study was to determine whether there is a relationship between the frequency of meconium-stained amniotic fluid (MSAF) and the duration of labor in term singleton gestation. Methods The clinical characteristics of women who delivered term singleton live newborns between 2001 and 2006 were examined. The cases involving neonates with major congenital anomalies were excluded. Results (1) The frequency of MSAF in term pregnancies was 18.4% (806/4376); (2) MSAF was found in only 2.8% (28/1008) of women who delivered by elective cesarean, but in 23.1% (778/3368) of women who delivered after the onset of labor (p<0.001); (3) The longer the duration of labor (first stage, second stage, or total), the higher the frequency of MSAF (p<0.001 for each); this remained significant after adjusting for other confounding variables such as parity, duration of rupture of membranes, gestational age at delivery, and mode of delivery (p<0.001 for each). Conclusion MSAF was found in only 2.8% (28/1008) of women who delivered before the onset of labor, but in 23.1% (778/3368) of women who delivered after the onset of labor. The longer the duration of labor, the higher the risk of MSAF in term singleton gestation.

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Incidence of and factors associated with meconium staining of the amniotic fluid in a Nigerian University Teaching Hospital

Cited by 36 publications

References 9 publications

Neonatal outcome in meconium stained amniotic fluid: a hospital based study

Neonatal outcome in meconium stained amniotic fluid: a hospital based study

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

The frequency of meconium-stained amniotic fluid increases as a function of the duration of labor

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