Login Register Cart 0
Generic placeholder image

Current Women`s Health Reviews

Editor-in-Chief

ISSN (Print): 1573-4048
ISSN (Online): 1875-6581

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

Comparison of Umbilical Cord Arterial Blood Gas and Neonatal Outcomes in Women with and without Meconium-Stained Amniotic Fluid During Labor

Author(s): Sanaz Mousavi, Aisan Akhgari, Mahshid Dehghan*, Maryam Hoseinzadeh, Mojgan Mirghafourvand, Rosa Tafreshi and Leila Nikniaz

Volume 19, Issue 4, 2023

Published on: 16 November, 2022

Article ID: e040822207261 Pages: 5

DOI: 10.2174/1573404819666220804091008

Price: $65

Abstract

Introduction: Meconium-stained amniotic fluid (MSAF) may increase maternal and neonatal complications. The favorable mode of delivery is controversial in women with MSAF. This study aimed to compare umbilical cord arterial blood gas (ABG) and neonatal outcomes in deliveries complicated by meconium and clear amniotic fluid during the active phase of labor.

Materials and Methods: This observational study was performed on 144 term pregnant women (72 with MSAF and 72 with clear amniotic fluid) during the active phase of labor with ruptured membranes admitted to Al-Zahra and Taleghani hospitals in Tabriz, Iran, from June 2019 to June 2020. A checklist was used to record the ABG and neonatal outcomes.

Results: The frequency of cesarean delivery in the MSAF group (25%) was significantly higher than in the women with clear amniotic fluid (20%) (P = 0.006). There was no statistically significant difference between the groups regarding pH, base excess, PCO2, 1- and 5- minute Apgar scores, and neonatal intensive care unit (NICU) admission of the newborn due to MSAF (P> 0.05). There was no incidence of hypoxic-ischemic encephalopathy, sepsis, and seizure.

Conclusion: Given the non-significant difference between two groups of women with and without MSAF during labor in terms of neonatal outcomes and umbilical cord ABG, it seems that MSAF alone is not an indication for cesarean delivery. Thus, vaginal delivery is recommended in pregnant women with MSAF.

Keywords: Meconium-stained, amniotic fluid, Umbilical cord ABG, Pregnancy outcome, Respiratory, distress syndrome.

[1]
Maymon, E.; Chaim, W.; Furman, B.; Ghezzi, F.; Shoham, V.I.; Mazor, M. Meconium stained amniotic fluid in very low risk pregnancies at term gestation. Eur. J. Obstet. Gynecol. Reprod. Biol., 1998, 80(2), 169-173.
[http://dx.doi.org/10.1016/S0301-2115(98)00122-5] [PMID: 9846662]
[2]
Monen, L.; Hasaart, T.H.; Kuppens, S.M. The aetiology of meconium stained amniotic fluid: Pathologic hypoxia or physiologic foetal ripening? Early Hum. Dev., 2014, 90(7), 325-328.
[http://dx.doi.org/10.1016/j.earlhumdev.2014.04.003] [PMID: 24794302]
[3]
Ahmad Pour, M.; Zahed Pasha, Y. The management of delivery with meconium-stained amniotic fluid. Majallah-i Danishgah-i Ulum-i Pizishki-i Babul, 2002, 4(4), 37-44.
[4]
Pop, V.J.; Kuppens, S.M. Management strategy in case of meconium stained amniotic fluid. Early Hum. Dev., 2014, 90(7), 341-342.
[http://dx.doi.org/10.1016/j.earlhumdev.2014.04.004] [PMID: 24786385]
[5]
Hutton, E.K.; Thorpe, J. Consequences of meconium stained amniotic fluid: What does the evidence tell us? Early Hum. Dev., 2014, 90(7), 333-339.
[http://dx.doi.org/10.1016/j.earlhumdev.2014.04.005] [PMID: 24794305]
[6]
Fanaroff, A.A. Meconium aspiration syndrome: Historical aspects. J. Perinatol., 2008, 28(3), S3-S7.
[http://dx.doi.org/10.1038/jp.2008.162] [PMID: 19057607]
[7]
Yeh, T.F. Core concepts: Meconium aspiration syndrome: Pathogenesis and current management. Neoreviews, 2010, 11(9), e503-e12.
[http://dx.doi.org/10.1542/neo.11-9-e503]
[8]
Dargaville, PA Respiratory support in meconium aspiration syndrome: A practical guide. Int. J. Pediatr., 2012, 2012, 965159.
[http://dx.doi.org/10.1155/2012/965159]
[9]
Ouladsahebmadarek, E.; Hoseinian, M.H.; Hamdi, K.; Ghojazadeh, M. Perinatal outcome in relation to mode of delivery in meconium stained neonates. Pakistan J. Med. Sci. Quarterly., 2012, 28(1), 13.
[10]
Yeomans, E.R.; Gilstrap, L.C., III; Leveno, K.J.; Burris, J.S. Meconium in the amniotic fluid and fetal acid base status. Obstet. Gynecol., 1989, 73(2), 175-178.
[PMID: 2911423]
[11]
Siriwachirachai, T.; Sangkomkamhang, US; Lumbiganon, P.; Laopaiboon, M. Antibiotics for meconium stained amniotic fluid in labour for preventing maternal and neonatal infections. Cochrane Database Syst. Rev., 2014, 2014(11), CD007772.
[http://dx.doi.org/10.1002/14651858.CD007772.pub3]
[12]
Committee opinion No 689: Delivery of a newborn with meconium stained amniotic fluid. Obstet. Gynecol., 2017, 129(3), e33-e34.
[http://dx.doi.org/10.1097/AOG.0000000000001950] [PMID: 28225424]
[13]
Kattwinkel, J.; Perlman, J.M.; Aziz, K.; Colby, C.; Fairchild, K.; Gallagher, J.; Hazinski, M.F.; Halamek, L.P.; Kumar, P.; Little, G.; McGowan, J.E.; Nightengale, B.; Ramirez, M.M.; Ringer, S.; Simon, W.M.; Weiner, G.M.; Wyckoff, M.; Zaichkin, J. Part 15: Neonatal resuscitation: 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation, 2010, 122(18), S909-S919.
[http://dx.doi.org/10.1161/CIRCULATIONAHA.110.971119] [PMID: 20956231]
[14]
Volpe, J.J. Neonatal encephalopathy: An inadequate term for hypoxic ischemic encephalopathy. Ann. Neurol., 2012, 72(2), 156-166.
[http://dx.doi.org/10.1002/ana.23647] [PMID: 22926849]
[15]
Mundhra, R.; Agarwal, M. Fetal outcome in meconium stained deliveries. J. Clin. Diagn. Res., 2013, 7(12), 2874-2876.
[PMID: 24551662]
[16]
Shaikh, E.M.; Mehmood, S.; Shaikh, M.A. Neonatal outcome in meconium stained amniotic fluid one year experience. J. Pak. Med. Assoc., 2010, 60(9), 711-714.
[PMID: 21381573]
[17]
Prevention of meconium aspiration syndrome: An update and the Baylor experience; Whitfield, J.M.; Charsha, D.S.; Chiruvolu, A., Eds.; Baylor University Medical Center Proceedings; Taylor & Francis, 2009, 22, pp. (2)128-131.
[18]
Lee, J.; Romero, R.; Lee, KA; Kim, EN; Korzeniewski, SJ Chaemsaithong, P Meconium aspiration syndrome: A role for fetal systemic inflammation. Am. J. Obstet. Gynecol., 2016, 214(3), 366.
[http://dx.doi.org/10.1016/j.ajog.2015.10.009]
[19]
Blackwell, S.C.; Moldenhauer, J.; Hassan, S.S.; Redman, M.E.; Refuerzo, J.S.; Berry, S.M.; Sorokin, Y. Meconium aspiration syndrome in term neonates with normal acid base status at delivery: Is it different? Am. J. Obstet. Gynecol., 2001, 184(7), 1422-1425.
[http://dx.doi.org/10.1067/mob.2001.115120] [PMID: 11408862]
[20]
Dollberg, S.; Livny, S.; Mordecheyev, N.; Mimouni, F.B. Nucleated red blood cells in meconium aspiration syndrome. Obstet. Gynecol., 2001, 97(4), 593-596.
[PMID: 11275033]
[21]
Ramin, K.D.; Leveno, K.J.; Kelly, M.A.; Carmody, T.J. Amniotic fluid meconium: A fetal environmental hazard. Obstet. Gynecol., 1996, 87(2), 181-184.
[http://dx.doi.org/10.1016/0029-7844(95)00403-3] [PMID: 8559519]
[22]
Wong, S.F.; Chow, K.M.; Ho, L.C. The relative risk of ‘fetal distress’ in pregnancy associated with meconium stained liquor at different gestation. J. Obstet. Gynaecol., 2002, 22(6), 594-599.
[http://dx.doi.org/10.1080/0144361021000020333] [PMID: 12554243]
[23]
Naeimi, S.; Ghiam, A.F.; Mojtahedi, Z.; Dehaghani, A.S.; Amani, D.; Ghaderi, A. Interleukin-18 gene promoter polymorphisms and recurrent spontaneous abortion. Eur. J. Obstet. Gynecol. Reprod. Biol., 2006, 128(1-2), 5-9.
[http://dx.doi.org/10.1016/j.ejogrb.2006.02.012] [PMID: 16584830]
[24]
Scott, H.; Walker, M.; Gruslin, A. Significance of meconium stained amniotic fluid in the preterm population. J. Perinatol., 2001, 21(3), 174-177.
[http://dx.doi.org/10.1038/sj.jp.7200521] [PMID: 11503104]
[25]
Ward, C.; Caughey, A.B. The risk of meconium aspiration syndrome (MAS) increases with gestational age at term. J. Matern. Fetal Neonatal Med., 2022, 35(1), 155-160.
[http://dx.doi.org/10.1080/14767058.2020.1713744] [PMID: 32233692]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy