Intrauterine Meconium Aspiration

Brown, Barry L.; Gleicher, Norbert; Scarpelli, Emile M.

doi:10.1097/00132582-198106000-00004

Cited by 27 publications

(33 citation statements)

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“…5 Passage of meconium in utero with staining of the amniotic fluid occurs in 12% to 16% of all deliveries. [6][7][8][9] Presence of meconium below the vocal cord is known as meconium aspiration and this finding occurs in 20% to 30% of all infants with meconium stained amniotic fluid with around 12% mortality. 7,9 Aspiration can occur in utero with fetal gasping or after birth with the first breaths of life.…”

Section: Introductionmentioning

confidence: 99%

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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Section: Introductionmentioning

confidence: 99%

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

Singh¹,

Singh²,

Thapar³

2017

Int J Contemp Pediatr

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“…It has been reported to occur in 1.7 to 35.8% of cases complicated with MSAF, and 1 to 3% of liveborn infants. 1,[12][13][14] The case fatality rate of MAS has been reported to be high, ranging from 5 to 40%. 1,[13][14][15][16][17] Approximately one-third of babies with MAS require intubation and mechanical ventilation, and other new therapies such as high frequency ventilation, inhaled nitric oxide and surfactant administration, although the effectiveness of certain of these technologies remain controversial.…”

Section: Introductionmentioning

confidence: 99%

Obstetric approaches to the prevention of meconium aspiration syndrome

Wei

Fraser

2008

J Perinatol

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Meconium aspiration syndrome (MAS) is associated with increased risk for perinatal mortality and morbidities. To provide an overview of the advances in our knowledge concerning the obstetric approaches to the prevention of MAS. The evidence of the effectiveness of intrapartum surveillance, amnioinfusion, and delivery room management in the prevention of MAS are reviewed in the present paper. Meconium aspiration syndrome remains one of the most common but challenging conditions for obstetricians and pediatricians. The available evidence did not demonstrate a beneficial effect of either of obstetric strategies in the prevention of MAS.

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“…MAS has been reported to occur in 6.6-30% of cases complicated with MSAF and in 1-3% of liveborn infants. [7][8][9] The case fatality rate of MAS has been reported to be high, ranging from 5 to 40%. 8,[10][11][12] Amnioinfusion (AI), or transcervical infusion of saline into the amniotic cavity, has been proposed as a method to reduce MAS.…”

Section: Introductionmentioning

confidence: 99%

Intrapartum amnioinfusion for meconium‐stained amniotic fluid: a systematic review of randomised controlled trials

Hofmeyr

Roy

et al. 2007

BJOG

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Background Amnioinfusion (AI) is thought to dilute meconium when present in the amniotic fluid and so reduces the risk of meconium aspiration.Objectives To evaluate if AI reduces meconium aspiration syndrome (MAS) and other indicators of morbidity in babies born to women with meconium-stained amniotic fluid (MSAF). Selection criteria Randomised trials comparing AI with no AI for women in labour with MSAF. Trial quality was evaluated using pre-established criteria.Data collection and analysis The following morbidity indicators were assessed: MAS, 5-minute Apgar score < 7, arterial cord pH < 7.2, and caesarean section. Studies were stratified according to the level of peripartum surveillance (standard versus limited).Typical relative risks (RRs) with their 95% confidence intervals were calculated for each outcome using a random effects model. Main resultsIn clinical settings with standard peripartum surveillance, we found no evidence that AI reduced the risk of MAS (RR 0.59, 95% CI 0.28-1.25), 5-minute Apgar score < 7 (RR 0.90, 95% CI 0.58-1.41), or caesarean delivery (RR 0.89, 95% CI 0.73-1.10). In clinical settings with limited peripartum surveillance, AI appeared to reduce the risk of MAS (RR 0.25, 95% CI 0.13-0.47).Conclusion In clinical settings with standard peripartum surveillance, the evidence does not support the use of AI for MSAF. In settings with limited peripartum surveillance, where complications of MSAF are common, AI appears to reduce the risk of MAS. However, this finding requires confirmation by further studies.

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Intrauterine Meconium Aspiration

Cited by 27 publications

References 0 publications

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

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

Obstetric approaches to the prevention of meconium aspiration syndrome

Intrapartum amnioinfusion for meconium‐stained amniotic fluid: a systematic review of randomised controlled trials

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