An Impact of Meconium Stained Liquor on Perinatal Outcome
- 1. Junior Resident, Department of Obstetrics and Gynaecology, Bharati Vidyapeeth (Deemed to be University) Medical College and Hospital, Sangli, India
- 2. Professor, Department of Obstetrics and Gynaecology, Bharati Vidyapeeth(Deemed to be University) Medical College and Hospital, Sangli, India.
Description
Background: Meconium stained amniotic fluid is associated with increased frequency of operative delivery, birth asphyxia, neonatal sepsis, NICU admissions. Thus, early detection and timely interventions are necessary to reduce the complications. The presence of abnormal fetal heart rate detected in the non-stress test along with the meconium stained amniotic fluid is a definite indication of fetal compromise. The Apgar scores calculated at 1 min and 5 min give us an idea of the impact caused by the meconium staining on the neonate. Materials and Methods: This study is carried out in the department of obstetrics in a tertiary care centre. This is a prospective observational study involving all the patients who deliver with meconium stained liquor for 6 months of duration. The meconium stained liquor is classified into 3 grades and fetal heart rate abnormalities recorded using non-stress test are noted. The Apgar score of the neonates is noted at 1 minute and 5 minutes of birth. The evidence of cord around neck, IUGR, postmaturity, congenital anomalies are looked for and the reasons for NICU admission are listed. Results: The meconium staining is associated with increased rate of caesarean section (59.7%), increased NICU admissions (61.4%) and more common in primigravida patients (56.1%). An equal association of the grade 2 and 3 meconium is seen with non-reactive non-stress test (both 66.66%). 78.9% of the neonates have low Apgar score at 1 min whereas only 52.6% of the neonates at 5 min. The main cause of the meconium staining is found to be placental insufficiency (26.3%) followed by oligohydramnios (24.5%). The most common reasons for NICU admissions are respiratory distress (45.7%) followed by Meconium aspiration syndrome (22.8%) and neonatal sepsis (17.1%). The neonatal morbidity rate is found to be 61.4% whereas the neonatal mortality rate is 17.5% which is significant. Conclusion: The presence of meconium stained liquor is a serious sign of intrauterine fetal compromise, associated with raise in neonatal morbidity. Thick meconium stained liquor along with Non-reactive NST is significantly associated with higher caesarean section rate, low Apgar score, NICU admissions, neonatal morbidity. It is associated with increased risk of adverse neonatal outcomes such as MAS, perinatal asphyxia which leads to perinatal and neonatal morbidity and mortality. The clinical significance is that meconium staining alerts the obstetrician to do the early intervention and also to look for other signs of fetal compromise.
Abstract (English)
Background: Meconium stained amniotic fluid is associated with increased frequency of operative delivery, birth asphyxia, neonatal sepsis, NICU admissions. Thus, early detection and timely interventions are necessary to reduce the complications. The presence of abnormal fetal heart rate detected in the non-stress test along with the meconium stained amniotic fluid is a definite indication of fetal compromise. The Apgar scores calculated at 1 min and 5 min give us an idea of the impact caused by the meconium staining on the neonate. Materials and Methods: This study is carried out in the department of obstetrics in a tertiary care centre. This is a prospective observational study involving all the patients who deliver with meconium stained liquor for 6 months of duration. The meconium stained liquor is classified into 3 grades and fetal heart rate abnormalities recorded using non-stress test are noted. The Apgar score of the neonates is noted at 1 minute and 5 minutes of birth. The evidence of cord around neck, IUGR, postmaturity, congenital anomalies are looked for and the reasons for NICU admission are listed. Results: The meconium staining is associated with increased rate of caesarean section (59.7%), increased NICU admissions (61.4%) and more common in primigravida patients (56.1%). An equal association of the grade 2 and 3 meconium is seen with non-reactive non-stress test (both 66.66%). 78.9% of the neonates have low Apgar score at 1 min whereas only 52.6% of the neonates at 5 min. The main cause of the meconium staining is found to be placental insufficiency (26.3%) followed by oligohydramnios (24.5%). The most common reasons for NICU admissions are respiratory distress (45.7%) followed by Meconium aspiration syndrome (22.8%) and neonatal sepsis (17.1%). The neonatal morbidity rate is found to be 61.4% whereas the neonatal mortality rate is 17.5% which is significant. Conclusion: The presence of meconium stained liquor is a serious sign of intrauterine fetal compromise, associated with raise in neonatal morbidity. Thick meconium stained liquor along with Non-reactive NST is significantly associated with higher caesarean section rate, low Apgar score, NICU admissions, neonatal morbidity. It is associated with increased risk of adverse neonatal outcomes such as MAS, perinatal asphyxia which leads to perinatal and neonatal morbidity and mortality. The clinical significance is that meconium staining alerts the obstetrician to do the early intervention and also to look for other signs of fetal compromise.
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IJPCR,Vol16,Issue1,Article313.pdf
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Additional details
Dates
- Accepted
-
2023-01-18
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/16/IJPCR,Vol16,Issue1,Article313.pdf
- Development Status
- Active
References
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