International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Vol. 8, Issue 2, pp: (313-318), Month: October 2020 - March 2021, Available at: www.researchpublish.com
RISK FACTORS FOR MECONIUM STAINED AMNIOTIC FLUID AND ITS IMPLICATIONS Thirukumar Markandu Senior lecturer in obstetrics and gynaecology, Department of clinical sciences, Faculty of Health Care Science, Eastern University, Sri Lanka dr.thiru10@yahoo.com Orcid number; https://orcid.org/0000-0001-8499-7175
Abstract: Objectives; The aim of the study was to identify the risk factors for MSAF and compare its outcome with clean amniotic fluid. Methods: A case control study was done in a Teaching Hospital Batticaloa, Sri Lanka over a period of two months in 2019.Seventy-five pregnant mothers with meconium stained amniotic fluid and Seventy-five pregnant mothers with clear amniotic fluid, were enrolled in the study group. Results; Majority of the study participants represented the 18 to 30 years age group (N=119:79.3%). A contributory association is observed Between induction of labour and child birth associated with meconium stained amniotic fluid (OR=2.05). Significantly higher number of babies with fatal distress were delivered by mothers identified with meconium stained amniotic fluid and significantly higher number of NICU admissions among them. It was possible to observe significantly higher number of normal deliveries among participants with meconium stained amniotic fluid and significantly higher number of child births occurred through LSCS were observed with meconium stained amniotic fluid. Conclusion; Meconium stained amniotic fluid in labour is associated with fetal distress, surgical intervention of child birth and NICU admission following delivery. Keywords: Meconium, Amniotic fluid, Child birth.
1. INTRODUCTION Meconium is a term derived from the Greek mekoni, meaning poppy juice or opium. It is the foetal intestinal content and can be found after 10 to 16 weeks of gestational age. It is dark greenish in colour, sterile and thick in consistency (1,2). Its constituents are 75% water, the remaining 25% consists of gastric secretions, bile salts, mucous secretion, vernix caseosa, lanugo hair, blood, pancreatic enzymes, free fatty acids, chemical substances like lipids, carbohydrates, nitrogen, electrolytes and squamous cells(3). A newborn usually passes meconium within the first 24 to 48 hours after birth. However, if baby passes meconium either before its birth, it gives meconium staining of amniotic fluid (MSAF), occurs in approximately 12 percent of all deliveries. The passage of meconium in utero occurs primarily in situations of advanced fetal maturity or fetal stress. Most infants who are delivered with meconium-stained amniotic fluid are 37 weeks of gestation or older; meconium rarely appears in amniotic fluid before 32 weeks of gestation. The exact pathological explanation for MSAF is not well studied but it is believed that fetus pass meconium from the fetal colon in response to hypoxia and may stimulate fetal gasping movements that result in meconium aspiration and that meconium therefore signals fetal compromise(4). It can also be due to several other reasons such as mesenteric vasoconstriction induced gut hyperperistalsis, falling umbilical venous saturation and vagal stimulation (4,5).
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