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Introduction Conclusions

References

1. Mode of Delivery and Fetal Outcome in Meconium Stained Amniotic Fluid (MSAF) in DMCH.Neke Akhtar FCPSa, Fazilatunnesa MBBSb, Sharmeen Yasmeen MPH, M Philc

2. A Population-Based Study of Meconium Aspiration Syndrome in Neonates Born between 37 and 43Weeks of GestationC. Fischer,1 C. Rybakowski,1 C. Ferdynus,2 P. Sagot,2, 3 and J. B. Gouyon1, 2

 

3. Obstetric Outcome of Meconium Stained Liquor in Labour S Arulkumaran, S C Yeoh, D M F Gibb, I Ingemarsson, S S Ratnam

 4. Meconium aspiration syndrome – the experience of a tertiary

centerM.C. Espinheira, M. Grilo, G. Rocha*, B. Guedes, H. Guimarães

 5. Fetal Outcome in Deliveries with Meconium Stained Liquor

Mst. Hosna Ara Khatun1, Jahanara Arzu2, Emdadul Haque3, Ma Kamal3, Mohammad Abdullah Al Mamun4, Mohammad Faizul Haque Khan4, Md. Mahbubul Hoque5

  6. Perinatal Outcomes Associated with Meconium-Stained

Amniotic Fluid in Japanese Singleton Pregnancies Misao Satomi, Yoshie Hiraizumi, Shunji Suzuki

7. Meconium Aspiration Syndrome: Pathophysiology andPrevention Mary Celeste Klingner, MD, and Jerry Kruse, MD, MSPH

 

Meconium aspiration syndrome (MAS) is an infrequent but life-threatening respiratory disease affecting some of the infants born through meconium-stained amniotic fluid. Meconium is the green viscous fluid that consists of fetal gastrointestinal secretions, cellular debris, mucus, blood, lanugo, and vernix. Meconium stained amniotic fluid is seen in 10% of predominantly term, growth restriction and post term deliveries. The presence of meconium in the amniotic fluid suggests in utero asphyxia, hypoxia and acidosis. Hypoxia causes increased gastrointestinal peristalsis and relaxed anal sphincter tone. Transient compression of the umbilical cord or fetal head also causes a vagal response, which can result in meconium passage. Meconium aspiration syndrome may occur in utero, in a distressed, gasping fetus, but more often meconium is aspirated into the lung immediately after delivery. This finding occurs in 20% to 30% of all infants with meconium-stained amniotic fluid. Meconium aspiration syndrome classically has been defined as respiratory distress that develops shortly after birth, with radiographic evidence of aspiration pneumonitis and a history of meconium-stained fluid.

This study showed that, meconium stained liquor were not associated with poor Apgar Score or metabolic acidosis but associated with meconium aspiration syndrome. Majority of patients has successful vaginal deliveries with good Apgar Score, however vigilance fetal monitoring during intrapartum are required to all patients with meconium stained liquor to prevent neonatal morbidity and mortality.

Method

A total 165 woman with various degree of meconium stained amniotic fluid were studied from delivery records. Patients’ demographic data and outcome of babies were studied including antenatal problems, mode of delivery, Apgar Score, arterial cord blood gas (cord blood ABG), Special Care Nursery (SCN) or Neonatal Intensive Care Unit (NICU) admission. Fetal heart rate monitoring record (cardiotocograph-CTG) were noted and interpreted as normal, suspicious or pathological. A structured questionnaires and a check list was used as the data collection instruments. The data obtained were recorded in Microsoft excel and analysed. 

Outcome of Baby with Meconium Stained Liquor HTF’s ExperienceMaizuriati AR, Noor Aini H

Department Obstetrics & Gynaecology, Hospital Tuanku Fauziah, Kangar, Perlis, Malaysia

Objective

The study was done to look for outcome of baby with meconium stained liquor at Hospital Tuanku Fauziah, Kangar, Perlis. The study was planned so that the fetal morbidity can be predicted and early intervention can be done.

Among all babies, 104 cases (63%) had normal CTG, 32 cases (19.4%) had suspicious CTG, 22 cases (13%) had pathological CTG and 7 cases (4.2%) had no CTG documentation. Majority of women with normal CTG were light meconium stained liquor (LMSL) whereas majority of suspicious and pathological CTG detected in moderate meconium stained liquor (MMSL).

This retrospective study was carried out in Obstetrics and Gynaecology Department of Hospital Tuanku Fauziah, Kangar, Perlis, Malaysia for period of 7 months, from 1st June 2010 to 31st December 2010. This study included both either meconium stained liquor detected during intrapartum or during delivery. Light meconium stained liquor (LMSL) was translucent and light yellow green in colour, moderate meconium stained liquor (MMSL) was green with particles in colour and thick meconium stained liquor (TMSL) was opaque and deep green in colour.

Results

Total deliveries at Hospital Tuanku Fauziah, Kangar, Perlis during that study period were 2425. Incidence of meconium stained amniotic fluid (MSAF) in this study was 165 cases (6.8%). Most of the mothers with MSAF (38.2 %) were in the age group of 25-29 years. About 21.8% and 20.6% are in the age group of 30-34 years and 20-24 years respectively. Majority of the women within parity 2 to 5 which consist of (58.8%) and 40% of women are primigravida. Majority of the mothers with MSAF were within the gestational age 38-40 weeks (80%). Majority of babies were normal weight (2.5 – 3.99 kg) which was 92.1%, only 6.1% were low birth weight (<2.5kg) and 1.8% were macrosomic baby with birth weight (>4.0kg).

Cord blood ABG (pH) No Percentage (%)<7 0 0

7 to <7.2 1 0.6>7.2 58 35.2

Not taken 106 64.2Total 165 100

Cord blood arterial blood gas (cord blood ABG)

Majority of babies (160 cases, 97.0%) had good Apgar Score with only 5 babies (3.0%) were intubated. Only 1 case (0.6%) with abnormal cord blood ABG (metabolic acidosis), 58 cases (35.2%) with normal readings and the rest of 106 cases (64.2%) data were not available. From this study, 38 cases (23%) were diagnosed with meconium aspiration syndrome (MAS) with 1 of them (2.63%) died at Day 4 of life due to severe MAS.