Clinical study of babies born through meconium stained amniotic fluid

Authors

  • Shilpasri Y. M. Department of Paediatrics, Sridevi Institute of Medical Sciences and Research Hospital, Tumkur, Karnataka, India
  • Madhurya B. Department of Paediatrics, Government Medical College, Mahabubnagar, Telangana, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20190687

Abstract

Background: Meconium stained amniotic fluid has been considered a sign of fetal distress and associated with poor fetal outcome, but others considered meconium passage by fetus is physiological phenomena and produce environmental hazards to fetus before birth. Such magnitude of different opinion was the object behind taking up of this study and aim was to find out incidence and effect of meconium in terms of morbidity and mortality.

Methods: Two hundred babies born with meconium stained amniotic fluid considering the inclusion and exclusion criteria from December 2012 to June 2013 in the Department of Paediatrics, Cheluvamba hospital attached to Mysore Medical College and Research Institute, Mysore. Fetal monitoring, mode of delivery, Apgar score, birth weight, resuscitation of baby are noted. All babies followed-up up to 1st week of neonatal life.

Results: In present study 200 babies born through meconium stained amniotic fluid was randomly selected-thin 37% and thick 63%. Major complications like birth asphyxia, meconium aspiration syndrome, early neonatal death seen in 5.5% (11 cases), morbidity in 37%, 12.5% in thin and 24.5% in thick MSAF. Causes of death were meconium aspiration syndrome in 3 cases, sepsis in 1 case, pneumonia in 1 case and birth asphyxia in 6 cases.

Conclusions: Immediate airway management, need for suction and intubation should be guided by state of newborn rather than presence of meconium. Timely diagnosis and management of meconium stained amniotic fluid may improve fetal outcome. From present study authors conclude that MSAF adversely affect fetal outcome mostly by thick meconium.

References

Williams JW. Williams Obstetrics. 1st ed. New York, Appleton; 1903.

William Taeusch H, Roberta A. Ballard, Christine A Gleason. Avery’s Diseases of the Newborn. 8th ed. Elsevier Canada; 2005:712-714.

Sedaghatian MR, Othman L, Rashid N, Ramachandran P, Bener AB. An 8-year study of meconium stained amniotic fluid in different ethnic groups. Kuwait Med J. 2004;36(4):266-9.

John P Cloherty, Eric C. Eichenwald, Anne R Hansen, Ann R Stark, Cloherty Manual of Neonatal Care. 7th ed. Lippincott Williams and Wilkins; 2012:429-434.

de Dios González J, Moya MB, Barbal AR, Dura TT, Juste MR, Castaño CI, et al. Neonatal morbidity associated with meconial amniotic fluid. An Esp Pediatr. 1998;48(1):54-9.

Leu M. Meconium aspiration. Arpeggione. 2007;1:31.

Gelfand SL, Fanaroff JM, Walsh MC. Meconium stained fluid: approach to the mother and the baby. Pediatric Clinics. 2004;51(3):655-67.

Carreno CA, Hassan SS, Redman M, Sorokin Y, Berry SM, Wolfe HM. Meconium passage in term pregnancies occurs independent of AF volume, Am J Obstet Gynecol. 2000;182(10):109.

Lucas A, Christofides ND, Adrian TE. Fetal distress, meconium and motility. Lancet. 1989;313(8118):718.

Robert Kliegman, Bonita Stanton, Richard Behrman, Joseph St. Geme, Nina Schor, Nelson Textbook of Pediatrics. 19th ed. New York: Elsevier; 1997:742-745.

Gary Cunningham F, Kenneth J Leveno, Steven L Bloom, John C Hauth, Dwight Rouse, Catherine Y Spong, Williams Textbook of Obstetrics. 23rd ed. New York: Murphy and Associates; 2009:431.

Klingner MC, Kruse J. Meconium aspiration syndrome: Pathophysiology and prevention. JAM Board Fam Pract. 1999;12(6):446-50.

Golde G Dudell, Barbara J Stoll. Respiratory tract disorder. In: Kliegman, ed. Nelson Text Book of Paediatrics. 18th ed. Philadelphia: Saunders; 2007.

Goodlin RL. Meconium aspiration. Obstet Gynecol. 1968;32:94.

Fujikura T, Klionsky B. The significance of meconium staining. Am J Obstet Gynecol. 1975;121(1):45-50.

Miller FC, Sacks DA, Yeh SY, Paul RH, Schifrin BS, Martin Jr CB, et al. Significance of meconium during labour. Am J Obstet Gynecol. 1975;122(5):573-80.

Naveen S, Kumar SV, Ritu S, Kushia P. Predictors of meconium stained amniotic fluid: a possible strategy to reduce neonatal morbidity and mortality. J Obstet Gynecol India. 2006;56(6):514-7.

Narlı N, Kırımi E, Satar M, Türkmen M, Halaza M, Yapıcıoğlu H. Evaluation and management of neonates with meconium stained amniotic fluid. East J Med. 2001;6(1):18-21.

Nayak AH, Dalal AR. Meconium staining of amniotic fluid significance and fetal outcome. J Obstet Gynaecol India. 1991;41:480-3.

Ziadeh SM, Sunna E. Obstretic and perinatal outcome of pregnancies with term labour and meconium stained amniotic fluid. Arch Gynaecol Obstret. 2000;264(2):84-7.

Narang A, Nair PMC, Bhakoo ON, Vashist K. Management of meconium sainted amniotic fluid: A team approach. Indian Pediatr. 1993;30:9-13.

Gokhroo K, Sharma U, Sharma M. Various maternal factors responsible for meconium stained amniotic fluid. J Obstet Gynecol India. 2001;51:6.

Debdas AK, Kaur T. Meconium stained liquor- Reappraisal. J Obstet Gynecol India. 1981;31:924-9.

Hellman LM, Schiffer MA, Kohl SG, Tolles WE. Studies in fetal wellbeing; Variations in fetal heart rate. Am J Obstet Gynecol. 1958;76:998-1012.

Goud P, Krishna U. Significance of meconium staining of amniotic fluid in labour. J Obstet Gynecol India. 1989;39:523-6.

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Published

2019-02-23

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Original Research Articles