Meconium-Stained Amniotic Fluid and Its Perinatal Feto-maternal Outcome

Md Mahbubur Rahman, A. Amin, Md.Abdul Quader
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Abstract

Meconium Stained Amniotic Fluid is associated with increased risk of operative delivery or caesarean section and increased rate of neonatal resuscitation, morbidity and mortality. A hospital-based prospective, observational study was conducted in the Obstetrics & Gynecology Department, NICU and Neonatal Ward of Naval Base Hospital, a tertiary care hospital of Bangladesh Navy, Chattogram, Bangladesh, between January 2020 and December 2021. A semi-structured questionnaire was prepared for both case and control group. 182 cases were enrolled as case and another 182 cases were as control. Antenatal checkup was significantly less in cases (p<0.05). Mean weight was 2.8±0.4 Kg in cases and in control 2.7±0.5 Kg (p<0.01). Mean fetal heart rate were 140±10.5 beats/min in cases and in control 135.7±7.2 beats/min (p<0.01). Apgar scores at 1st minute and fifth minutes were significantly lower in cases (7±1.4 and 8.2±1.2 respectively) in comparison to control (7.5±0.3 and 9.2±1.1 respectively). Obstetric outcome of labor, that is mode of delivery was significantly dictated by the presence of MSAF. There were more than half (57.1%) of the cases were having grade three MSAF, whereas grade one and grade two were 14.8% and 28% respectively. Perinatal asphyxia, 5 min APGAR score <7, oropharyngeal suction needed, EONS, MAS, admission in NICU/Neonatal ward and neonatal death all were significantly higher in MASF group. MSAF is associated with increased need for neonatal resuscitation, higher risk of perinatal asphyxia, MAS, hospital admission and mortality for fetus and higher risk for operative delivery. CBMJ 2022 July: vol. 11 no. 02 P: 114-119
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羊水粪染色及其围产期胎母结局
羊水粪染色与手术分娩或剖宫产风险增加、新生儿复苏率、发病率和死亡率增加有关。2020年1月至2021年12月,在孟加拉国海军三级医院海军基地医院妇产科、新生儿重症监护室和新生儿病房进行了一项以医院为基础的前瞻性观察研究。对病例组和对照组分别进行半结构化问卷调查。182例作为病例,182例作为对照。产前检查明显少于对照组(p<0.05)。患者平均体重为2.8±0.4 Kg,对照组为2.7±0.5 Kg (p<0.01)。平均胎心率为140±10.5次/min,对照组为135.7±7.2次/min (p<0.01)。第1分钟和第5分钟Apgar评分(分别为7±1.4和8.2±1.2)明显低于对照组(分别为7.5±0.3和9.2±1.1)。分娩的产科结果,即分娩方式是由MSAF的存在显着决定的。超过一半(57.1%)的病例为三级MSAF,一级和二级MSAF分别为14.8%和28%。围产儿窒息、5 min APGAR评分<7分、需要口咽吸痰、EONS、MAS、NICU/新生儿病房入院及新生儿死亡均显著高于MASF组。MSAF与新生儿复苏需求增加、围产期窒息、MAS、住院和胎儿死亡率增加以及手术分娩风险增加有关。《中国医学杂志》2022年7月第11期[02:14 . 119
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