STUDY ON MECONIUM STAINED FLUID-PERINATAL OUTCOME
Journal Title: International Journal Of Advances In Gynaecology - Year 2018, Vol 1, Issue 2
Abstract
Background and objectives: Meconium stained amniotic fluid has always remained an enigma among obstetricians as it has been considered a sign of fetal distress since centuries. The perinatal morbidity associated with MSAF has been studied in many studies, though some have described it as a physiological phenomenon due to the maturation of the gastrointestinal tract. Such magnitude of different opinion was the object behind taking up of this study and the objective of this study is to find a correlation between the presence of MSAF in mothers with co- morbidities like PIH and GDM and to study the fetal heart variability in cases with MSAF and the significance of an admission test. This study also throws a light on the perinatal outcomes associated with MSAF. Methods: 100 women in labor with meconium stained amniotic fluid were taken in this study taking all the inclusion and exclusion criteria into consideration. This study was conducted in K.S HEGDE charitable hospital from October 2014 to September 2016. A detailed history with clinical examination along with investigations were done .An admission test was done for all patients, along with continuous fetal heart monitoring was done in the presence of MSAF. Effect of thin and thick meconium on fetus was studied. The cases with maternal co –morbidities were closely monitored along with the mode of delivery, Apgar score, birth weight, resuscitation of baby were studied . All the newborns born through meconium stained liquor were followed up to one week of neonatal life. Statistics: This was a prospective study done during a period of 23 months. The sampling technique was universal sampling. Pearsons correlation coefficient was obtained to study the relation. The p value of < 0.05 was considered as significant. Results: Out of a total of 100 cases there was 60 cases with thick meconium, with a non-reactive NST seen in 65% cases with thick MSAF and 32.5% cases with thin MSAF. 79% of cases with MSAF underwent emergency LSCS. The incidence of MSAF among PROM cases was 21%, 4% in cases with PIH, 11% in cases with GDM and 2 % among cases with previous LSCS. The neonatal complications were more with thick meconium stained liquor accounting to 28.3% incidence of MAS, 23.3% of sepsis, 3.3%of pneumonitis and 21.7% of birth asphyxia. Conclusion: This study ascertained the need for an admission test and continuous CTG monitoring in cases detected to have meconium stained amniotic fluid. The timely diagnosis of MSAF and intervention can improve the fetal outcome. There co-morbidities among mothers like GDM did have a small role to play though the incidence was not very high. The neonatal complications were more common among cases with thick meconium stained liquor and probably the use of procedures like amnioinfusion can bring down the incidence of perinatal morbidity along with the rate of caesarean sections .
Authors and Affiliations
Dr. Soumya Harikumar, Dr. Aparna Rajesh
Keywords
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