The study was carried out after obtaining approval from the Aga Khan University Hospital ethical review committee. Patients with gestational age >37 weeks, cephalic presentation, who presented with meconium stained liquor after spontaneous or artificial rupture of membranes during labour were enrolled and their records were reviewed, while all neonates with congenital anomalies were excluded. AKHW-Garden is a secondary care and a private teaching hospital caters to a class of patients that belong to lower and middle class social strata. This retrospective study was conducted at the Level-II Nursery of Agha Khan Hospital for Women (AKHW) Garden, from January 2013 – December 2013. Aim of this study was to determine the maternal factors and neonatal outcome of pregnancy complicated by meconium stained amniotic fluid. Therefore identification of maternal factors may help to anticipate the need for neonatal resuscitation in delivery room which eventually helps to improve the perinatal outcome and reduce perinatal mortality and morbidity associated with MSAF. 5 MSAF is associated with higher rate of caesarean delivery, instrumental delivery, NICU admission rate, fetal distress, low birth weight and neonatal death. MSAF predisposes perinatal mortality even in women with very low risk for obstetric complications. 7 Meconium stained neonates are more prone to develop respiratory distress than neonates born with clear fluid. 6 Placental insufficiency, maternal hypertension, pre-eclampsia, oligohydramnios or maternal drug abuse (tobacco, cocaine) are predisposing factors of in utero passage of meconium. Vagal stimulation from umbilical cord compression causing fetal hypoxic stress, resulting in increased peristalsis and relaxation of anal sphincter leading to intrauterine passage of meconium. 4 Passage of meconium is not common before 34 weeks of gestation, beyond that period the incidence gradually increases. 3 One such attribute is MSAF, 27.3% of neonatal deaths had a history of or evidence of meconium passage during delivery. 2 Unfortunately Pakistan is number three among those ten countries who contribute two-thirds of the world’s neonatal deaths with an estimated neonatal mortality rate of live births. MAS contributes to neonatal death in up to 0.05% (i.e. Incidence of meconium stained amniotic fluid ranges from 7-22% 1 while meconium aspiration syndrome (MAS) occurs in approximately 5% of all cases of MSAF. Meconium passage in a premature baby most often means the baby developed an infection while in the womb.Meconium stained amniotic fluid (MSAF) is an alarming sign of fetal compromise and associated with a poor perinatal outcome. Depending on when they are born, preterm newborns have underdeveloped organs, which may not be ready to function outside of. read more, it is never normal for there to be meconium noted at the delivery of a premature baby Preterm (Premature) Newborns A preterm newborn is a baby delivered before 37 weeks of gestation. Near the end of a term pregnancy, the function of the placenta decreases, providing fewer nutrients and less oxygen to the. Although meconium passage may be normal in a term or postmature fetus Postterm Newborns A postterm newborn is a baby delivered after 42 weeks of gestation. But sometimes meconium passage occurs in response to stress, such as by an infection or by an inadequate level of oxygen in the blood. Passage of meconium may be normal before birth, particularly just before or after the due date. Meconium is usually passed after birth when newborns start to feed, but sometimes it is passed into the amniotic fluid before or around the time of birth. Meconium is the dark green, sterile fecal material that is produced in the intestine before birth.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |