scholarly journals Influence of foetal inflammation on the development of meconium aspiration syndrome in term neonates with meconium-stained amniotic fluid

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e7049 ◽  
Author(s):  
Kyoko Yokoi ◽  
Osuke Iwata ◽  
Satoru Kobayashi ◽  
Kanji Muramatsu ◽  
Haruo Goto
Keyword(s):  
Amniotic Fluid ◽  
Apgar Score ◽  
Neonatal Intensive Care ◽  
Meconium Aspiration Syndrome ◽  
Univariate Logistic Regression Analysis ◽  
Term Neonates ◽  
Meconium Aspiration ◽  
Independent Variable ◽  
Male Sex ◽  
Meconium Stained Amniotic Fluid

Background Meconium-stained amniotic fluid is observed in approximately 10–15% of all deliveries; however, only 5% of neonates with meconium-stained amniotic fluid develop meconium aspiration syndrome (MAS). Although foetal distress and subsequent sympathetic stimulation have been considered as the primary upstream events of MAS, this clinical complication sometimes occurs due to other pathologies, such as intraamniotic inflammation. The aim of this study was to investigate whether the incidence of MAS is associated with the presence of funisitis and chorioamnionitis in term neonates with meconium-stained amniotic fluid. Methods Between April 2013 and March 2015, a total of 95 term neonates with meconium-stained amniotic fluid, who were hospitalized at a neonatal intensive care unit, were enrolled in the study. The placenta and umbilical cord were histopathologically examined. Clinical variables and histopathological findings associated with the incidence of MAS were studied. Results A total of 36 neonates developed MAS. Univariate logistic regression analysis revealed that a heavier birth weight, male sex, 1-min Apgar score ≤ 7, funisitis (but not chorioamnionitis), and elevated acute-phase inflammatory reaction score were associated with increased incidence of MAS (all p < 0.05). The multivariate model comprised funisitis (OR = 5.03, 95% CI [1.63–15.5], 1-min Apgar score ≤ 7 (OR = 2.74, 95% CI [1.06–7.09], and male sex (OR = 3.4, 95% CI [1.24–9.34]. Conclusion In neonates with meconium-stained amniotic fluid, funisitis, as well as low 1-min Apgar score and male sex, was identified as an independent variable for MAS development. Intraamniotic inflammation might be involved in the pathological mechanisms of MAS.

scholarly journals Perinatal Outcome Associated with Meconium Stained Amniotic Fluid In Pregnancy

2015 ◽  
Vol 4 (2) ◽  
pp. 44-49 ◽  
Author(s):  
Nasrin Begum ◽  
Sharmeen Mahmood ◽  
Salma Akhter Munmun ◽  
MS Haque ◽  
KN Nahar ◽  
...  
Keyword(s):  
Birth Weight ◽  
Amniotic Fluid ◽  
Apgar Score ◽  
Perinatal Outcome ◽  
Perinatal Death ◽  
Mode Of Delivery ◽  
Neonatal Resuscitation ◽  
Meconium Aspiration Syndrome ◽  
Meconium Aspiration ◽  
Meconium Stained Amniotic Fluid

Objectives: To evaluate perinatal outcome associated with meconium stained amniotic fluid in pregnant women.Methods: It was a prospective cross sectional study, conducted in the Department of Obstetrics and Gynecology in Bangabandhu Sheikh Mujib Medical University, Dhaka, from January 2013 to December 2013. Total 50 pregnant women admitted in the labour ward for delivery with meconium stained amniotic fluid were the study population. Singleton pregnancy of more than 34 weeks duration was included and pregnancy with APH, breech presentation, congenital malformation of fetus, IUD were excluded from the study. Out of 50 patients two did not provide all the information needed to analyze the data and hence were excluded. Outcome Variables were gestational age, antenatal checkup, medical diseases of mother (HTN, Diabetes mellitus, Heart disease), obstetric complication (oligohydramnios, prolonged labour), mode of delivery, neonatal details (weight of the baby in kg, APGAR scoring at 1 min & 5 min), neonatal resuscitation, admission in neonatal ICU(NICU), neonatal complications (RDS, MAS, Neonatal death).Results: Over half (52.1%) of the neonates needed resuscitation and 54.2% admitted in ICU. About 90% of the neonates had normal birth weight and only 10.4% were of low birth weight. 14.6% of the neonates developed meconium aspiration syndrome and 10.4% respiratory distress syndrome. Neonatal jaundice and neonatal sepsis were observed in 4.2% neonates each. Four neonates (8.3%) died early in the neonatal life, while 1 (2.1 %) was still-born. Low APGAR score (<7) at 1 and 5 minutes of birth was found in 64.7% and 52.9% of the cases respectively with thick meconium stained amniotic fluid as opposed to 25.8% and 16.1% of the cases respectively having thin meconium stained amniotic fluid (p = 0.008 and p = 0.007 respectively). Thick meconium was significantly associated with meconium aspiration syndrome (p = 0.003). Neonates needing immediate resuscitation and admission in ICU was staggeringly higher in the former group than those in the later group (p = 0.002). The incidence of perinatal death was significantly higher in patients with thick meconium stained amniotic fluid than that in patients with thin meconium ( p= 0.021).Conclusion: Meconium stained amniotic fluid was associated with low APGAR score, higher incidence of MAS, ICU admission and perinatal death.J. Paediatr. Surg. Bangladesh 4(2): 44-49, 2013 (July)

scholarly journals Meconium Stained Amniotic Fluid – A Potential Predictor Of Meconium Aspiration Syndrome

1970 ◽  
Vol 28 (1) ◽  
pp. 3-6 ◽  
Author(s):  
P Swain ◽  
A Thapalial
Keyword(s):  
Amniotic Fluid ◽  
Apgar Score ◽  
Multiple Logistic Regression Analysis ◽  
Univariate Analysis ◽  
Significant Risk ◽  
Neonatal Morbidity ◽  
Meconium Aspiration Syndrome ◽  
Meconium Aspiration ◽  
Prolonged Labour ◽  
Meconium Stained Amniotic Fluid

Objective: To identify potential predictors of Meconium Aspiration Syndrome (MAS) in pregnancies complicated by meconium-stained amniotic fluid (MSAF) & to review the incidence, morbidity and mortality of Meconium Aspiration Syndrome (MAS). Methods: In the period of 2003 to 2006,175 pregnancies with thick meconium-stained AF were delivered; of these, 15 neonates developed MAS and 160 did not. The two groups were compared retrospectively according to maternal findings, pregnancy outcome, and neonatal complications, using univariate analysis (P < 0.05 considered significant) and stepwise multiple logistic regression analysis to identify independent significant factors for prediction of MAS. Results: Incidence of MSAF was 13.97% and that of MAS was 8.57%. All deliveries associated with thick MSAF had developed MAS. 40% mothers were associated with PROM & prolonged labour. Most common & significant risk factors associated with MAS were increased gestational age, increased cesarean section (LSCS) & low Apgar scores at 1 minute and 5 minute. Mortality rate was 6.66% & mechanical ventilation was used in only 1(6.66%) case. Conclusion: MAS are associated with higher incidence of LSCS, lower 1 minute & 5 minute Apgar score & higher gestational weeks. 40% mothers were associated with PROM & prolonged labour. The neonatal morbidity & mortality is significantly more frequent in relation to thick meconium stained amniotic fluid. Specific delivery room resuscitation procedure, early diagnosis & proper management can prevent development of MAS as well as morbidity & mortality. Key words: Meconium Stained Amniotic Fluid, Meconium Aspiration Syndrome and Apgar Score.   DOI = 10.3126/jnps.v28i1.1397 J. Nepal Paediatr. Soc. Vol.28(1) p.3-6

scholarly journals A Population-Based Study of Meconium Aspiration Syndrome in Neonates Born between 37 and 43 Weeks of Gestation

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
C. Fischer ◽  
C. Rybakowski ◽  
C. Ferdynus ◽  
P. Sagot ◽  
J. B. Gouyon
Keyword(s):  
Amniotic Fluid ◽  
Low Frequency ◽  
Population Based ◽  
Meconium Aspiration Syndrome ◽  
Population Based Study ◽  
Term Neonates ◽  
Meconium Aspiration ◽  
High Prevalence ◽  
Term Newborns ◽  
Meconium Stained Amniotic Fluid

The epidemiology of meconium aspiration syndrome (MAS) in term neonates is described in a population-based retrospective study of data recorded for all births from 2000 to 2007 in a French region (Burgundy). Of the 132 884 eligible term newborns, the rate of meconium-stained amniotic fluid (MSAF) was 7.93%. The prevalence of severe MAS was 0.067% in the overall population. MAS rate was 0.11% at 37-38 weeks of gestation (WG), 0.20% at 39–41 WG, and 0.49% at 42-43 WG. Factors independently associated with severe MAS were identified by a case-control study, that is, thick meconium amniotic fluid, fetal tachycardia, Apgar score ≤3 at 1 minute, and birth in a level III facility. Our results confirm the high prevalence of MSAF after 37 WG but also show the low frequency of severe MAS in a period corresponding to the new international recommendations on the management of birth with MSAF.

scholarly journals An observational study of meconium aspiration syndrome and its immediate outcome with relation to thick and thin meconium stained amniotic fluid

2018 ◽  
Vol 5 (2) ◽  
pp. 552
Author(s):  
Sushant Kumar ◽  
Minni Rani Akhouri
Keyword(s):  
Amniotic Fluid ◽  
Neonatal Intensive Care ◽  
Mode Of Delivery ◽  
Birth Asphyxia ◽  
Meconium Aspiration Syndrome ◽  
P Value ◽  
Meconium Aspiration ◽  
Clinical Criteria ◽  
The Mean ◽  
Meconium Stained Amniotic Fluid

Background: Meconium-stained amniotic fluid (MSAF) accounts for approximately 10-15% of live births and Meconium aspiration syndrome occurs in 5% among infants born through MSAF. The purpose of this study was to evaluate the outcome in neonates with meconium aspiration syndrome with regard to thin and thick meconium. Methods: A prospective cohort study of inborn neonates was done from April 2016 to August 2017 admitted in neonatal intensive care unit, Department of Paediatrics and Neonatology, RIMS, Ranchi after obtaining written informed consent from the parents or guardian and diagnosis of MAS was made depending on the clinical criteria and its clinical outcome was observed. MAS babies were studied on the basis of thin and thick meconium stained amniotic fluid.Results: The mean birth weight in thin meconium was 2760±394. The mean APGAR score in thin meconium at 1 minute (3.57±1.01) and 5 minutes (5.57±1.62) was significantly more than thick meconium. The mode of delivery in thin meconium was commonly by cesarean section (76.9%). There was need for resuscitation in 46.1% in thin meconium neonates which was significantly higher than neonates born with thick meconium 6.6% (P value 0.000). The most common complication in thin meconium was birth asphyxia (69.2%), followed by ARF and septicemia. Death was significantly higher in neonates born with thin meconium (69.2%)as compared to thick (20%) with P value of 0.000Conclusions: Amniotic fluid with thin meconium may cause more respiratory and other complications in neonates than amniotic fluid with thick meconium. Hence proper diagnosis and timely intervention can reduce the morbidity and mortality in neonates with meconium aspiration syndrome.

scholarly journals Value of Neutrophil to Lymphocyte Ratio in Early Prediction of Meconium Aspiration Syndrome

2020 ◽  
Vol 10 (01) ◽  
pp. e207-e211
Author(s):  
Suzan Gad ◽  
Abeer Alkhalafawi ◽  
Syed Raza ◽  
Mervat Hesham ◽  
Mohamed Sheta
Keyword(s):  
Risk Factors ◽  
Amniotic Fluid ◽  
Apgar Score ◽  
Significant Risk ◽  
Meconium Aspiration Syndrome ◽  
Neutrophil To Lymphocyte Ratio ◽  
Meconium Aspiration ◽  
Lymphocyte Ratio ◽  
Meconium Stained Amniotic Fluid ◽  
Minute Apgar Score

AbstractMeconium aspiration syndrome (MAS) is a serious neonatal condition. Prediction of MAS is challenging particularly in low-resource setting. Neutrophil to lymphocyte ratio (NLR) is a new simple index used for diagnosis of many inflammatory conditions. The present study was an attempt to determine whether NLR can predict the occurrence of MAS. The present study included 101 children with meconium-stained amniotic fluid. They comprised 22 patients who developed MAS and 79 neonates who didn't have the condition. All neonates were subjected to careful analysis of maternal and perinatal history in addition to thorough clinical assessment and radiological and laboratory evaluation. Blood samples from the umbilical cord were collected at birth and were used to obtain complete blood counts and C-reactive protein (CRP) assay. Univariate analysis revealed that elevated CRP levels, increased NLR, and 5-minute Apgar score of <7 were significant risk factors for the occurrence of MAS. Multivariate analysis revealed that low 5-minute Apgar score and increased NLR remained as significant risk factors of MAS. Receiver operating characteristic curve analysis showed good performance of NLR in prediction of MAS. NLR is useful in prediction of MAS in term neonates with meconium-stained amniotic fluid.

scholarly journals Study of early neonatal outcomes in babies delivered through meconium-stained amniotic fluid in a rural teaching hospital

2021 ◽  
Vol 8 (4) ◽  
pp. 642
Author(s):  
Venkatesh Dhannaram ◽  
Sumathi Kotapuri ◽  
Sudharshanraj Chitgupikar
Keyword(s):  
Respiratory Distress ◽  
Amniotic Fluid ◽  
Admission Rate ◽  
Meconium Aspiration Syndrome ◽  
Multiple Gestation ◽  
Meconium Aspiration ◽  
Emergency Cesarean ◽  
Nicu Admission ◽  
A Prospective Study ◽  
Meconium Stained Amniotic Fluid

Background: When the fetus is in a state of stress meconium is passed presence of meconium in amniotic fluid is potentially a serious Sign of fatal compromise, frequency of meconium strained amniotic fluid ranges from 5-22%. MSAF results in higher rate of cesarean delivery, NICU admission rate, respiratory distress, PPHN and neonatal death. The primary objectives of the study were to estimate the incidence of Meconium aspiration syndrome & Respiratory distress among babies born through meconium-stained amniotic fluid (MSAF) along with studying the outcomes at the end of 7 days.Methods: This was a prospective study undertaken in mediciti institute of medical sciences, Ghanpur Medchal Mandal from Jan 2018 to June 2019. Data was collected in a predetermined proforma after institutional ethical committee clearance and appropriate informed consent.Results: During this period 1972 neonates were delivered of which 216 babies were born through MSAF. 18 were excluded for non-cephalic presentation, multiple gestation or congenital anomalies.198 babies were included in the study (96 male and 102 female). 18 neonates (10.2%) needed resuscitation at birth. 85 (42.9%) had thick MSAF. 43 of them developed respiratory distress (21.7%). 10 babies were ventilated. Seizures, hyperbilirubinemia, thrombocytopenia were more common among babies with thick MSAF. Mortality was 1%.Conclusions: Thick meconium-stained amniotic fluid was associated with low Apgar score, higher rate of emergency cesarean section and meconium aspiration syndrome. Primigravida mothers, maternal hypothyroidism and oligohydramnios were important risk factors associated with MAS.

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