Background: Meconium stained amniotic fluid (MSAF) is frequently encountered in obstetric practice. Literature on the subject is still poorly documented in the African setting. Objective: The aim of this study was to ...Background: Meconium stained amniotic fluid (MSAF) is frequently encountered in obstetric practice. Literature on the subject is still poorly documented in the African setting. Objective: The aim of this study was to determine the maternal and fetal outcomes in case of meconium stained amniotic fluid observed during term labour. Materials and Methods: We conducted a prospective cohort study enrolling all consenting pregnant women with term singleton fetus in cephalic presentation admitted for labour with ruptured fetal membranes in the maternity units of the Yaoundé Central Hospital (YCH) and the Yaoundé Gynaeco-Obstetric and Pediatric Hospital (YGOPH) of Cameroon between December 2014 and April 2015. The exposed grouped was considered as participants having MSAF, while the non-exposed group comprised those with clear amniotic fluid (CAF). The two groups were monitored during labor using the WHO partograph, and then followed up till 72 hours after delivery. Variables studied included the colour and texture of amniotic fluid as well as maternal and fetal complications. Data was analyzed using Epi-info version 3.5.4. The chi-square and Fischer’s exact tests were appropriately used to compare the two groups. A p-value less than 5% was considered statistically significant. Results: 2376 vaginal deliveries were recorded during the study period among which MSAF was observed in 265 cases, hence a prevalence rate of MSAF of 11.15%. Among these cases of MSAF, 52.1% was thick meconium and 47.9% was light meconium. Maternal morbidity was high in the group with MSAF;these included: Higher proportions of caesarean delivery (RR = 2.35 p -4) and prolonged labor (RR = 3 p -4). In this same group, the incidences of chorioamnionitis and puerperal sepsis were low (0.94% and 0.70% respectively), although there was a three-fold higher risk that was not statistically significant (RR = 3, P = 0.31). Fetal and neonatal outcomes were poorer in the MSAF group compared to the CAF group. The complications included fetal heart rate abnormalities, low Apgar score at the 5th minute, need for neonatal resuscitation, neonatal asphyxia and neonatal infection which were significantly higher in the MSAF group (all p < 0.05). Meconium aspiration syndrome (MAS) was found in 2.34% of MSAF cases. Perinatal mortality was 2.34% and all cases of death occurred in the thick MSAF group. Conclusion: MSAF observed during labour is associated with increased perinatal morbidity and mortality. Its detection during labor should strongly indicate very rigorous intra partum and postpartum monitoring. This will ensure optimal management and reduction in the risks of complications.展开更多
Introduction: We examined the perinatal outcomes in Japanese singleton pregnancies associated with meconium-stained amniotic fluid (MSAF) in relation to gestational age at delivery. Methods: We reviewed the obstetric ...Introduction: We examined the perinatal outcomes in Japanese singleton pregnancies associated with meconium-stained amniotic fluid (MSAF) in relation to gestational age at delivery. Methods: We reviewed the obstetric records of all Japanese singleton deliveries after 22 weeks’ gestation managed at Japanese Red Cross Katsushika Maternity Hospital between 2002 and 2008 (n = 11,249). Results: The incidence of MSAF in the whole singleton pregnancies was 13%. The incidence of MSAF at preterm, term and post-term were 9.1%, 13% and 48%, respectively. The incidence of intrauterine fetal death, low Apgar score and low umbilical artery pH at delivery in cases with MSAF were significantly higher than those without MSAF in various gestational ages at delivery. Conclusion: Obstetric management should be affected by meconium in the amniotic fluid.展开更多
目的：探讨胎儿窘迫伴（或不伴）羊水粪染的新生儿脐血中8-异前列腺素（8-iso-PGF2α）水平的变化及其临床意义。方法：选取胎儿窘迫伴（或不伴）羊水粪染的新生儿152例,进行出生后1 min Apgar评分,按羊水粪染情况分为无粪染组36例和Ⅰ...目的：探讨胎儿窘迫伴（或不伴）羊水粪染的新生儿脐血中8-异前列腺素（8-iso-PGF2α）水平的变化及其临床意义。方法：选取胎儿窘迫伴（或不伴）羊水粪染的新生儿152例,进行出生后1 min Apgar评分,按羊水粪染情况分为无粪染组36例和Ⅰ度粪染组38例、Ⅱ度粪染组39例、Ⅲ度粪染组39例,并选取同期正常新生儿38例为对照组。采用双抗体夹心酶联免疫法检测五组新生儿脐血8-iso-PGF2α水平并对结果进行分析。结果：（1）胎儿窘迫病情越严重,患儿血清8-iso-PGF2α水平越高,体内氧化应激反应越严重,特别是羊水粪染≥Ⅱ度时,患儿血清8-iso-PGF2α水平明显高于正常新生儿、无或Ⅰ度粪染患儿（P〈0.05）;（2）Apgar评分≤8分患儿血清8-iso-PGF2α水平高于正常新生儿及9~10分患儿（P〈0.05）;（3）以8-iso-PGF2α水平为检验变量,是否窘迫为状态变量,作ROC曲线分析,曲线下面积（AUC）为0.880,95%CI为0.835-0.901,以8-iso-PGF2α水平判断是否有胎儿窘迫的Cut-off值为4.23 ng/m L。结论：胎儿窘迫的发生发展与过氧化损伤有关,脐血8-iso-PGF2α水平能够准确反映胎儿窘迫羊水粪染新生儿过氧化损伤的程度,与Apgar评分能够共同作为及时预测新生儿缺血缺氧性脑病发生的指标。展开更多
目的:分析胎粪污染羊水(MSAF)新生儿发生胎粪吸入综合征(MAS)的风险评估简表构建及预测效果。方法:收集2023年1月至2023年12月江西信丰县妇幼保健院收治的MSAF新生儿60例为研究对象,根据是否并发MAS分无MAS组、MAS组,回顾性收集两组患...目的:分析胎粪污染羊水(MSAF)新生儿发生胎粪吸入综合征(MAS)的风险评估简表构建及预测效果。方法:收集2023年1月至2023年12月江西信丰县妇幼保健院收治的MSAF新生儿60例为研究对象,根据是否并发MAS分无MAS组、MAS组,回顾性收集两组患儿一般资料、实验室检查指标、母亲一般资料等进行分析。应用多因素Logistic回归分析MSAF新生儿发生MAS的危险因素,基于危险因素构建MSAF新生儿发生MAS的风险评估简表,并采用受试者特征曲线(ROC)验证该风险评估简表的预测效果。结果:本研究共纳入60例MSAF新生儿,发生MAS的患儿21例(35.00%);MAS组1 min阿普加(Apgar)评分、胎膜早破发生率、羊水过少、外周血白细胞(WBC)、降钙素原(PCT)较无MAS组明显高(P<0.05);MAS组酸碱值(pH值)、碱剩余(BE值)较无MAS组明显低(P<0.05)。经多因素Logistic回归分析示,羊水过少、pH值、WBC及1 min Apgar评分(4个)是MSAF新生儿发生MAS的独立危险因素(P<0.05)。依据Logistic回归分析结果构建胎粪污染羊水新生儿发生MAS的风险评估简表,ROC分析显示其预测MAS的曲线下面积为0.955(95%CI:0.920~0.974),敏感性为85.71%,特异性为92.31%。结论:MSAF新生儿发生MAS的独立危险因素有羊水过少、pH值、WBC及1 min Apgar评分,以此构建风险评估简表模型,预测效果显著。展开更多
目的探讨Ⅲ度羊水污染对新生儿神经系统的影响。方法胎儿宫内窘迫患儿44例,其中Ⅲ度羊水污染20例作为观察组,其余24例患儿为对照组,2组患儿出生后1 min5、min、10 min给予Apgar评分;生后72 h行头颅CT检查;生后第3天、第14天行新生儿神...目的探讨Ⅲ度羊水污染对新生儿神经系统的影响。方法胎儿宫内窘迫患儿44例,其中Ⅲ度羊水污染20例作为观察组,其余24例患儿为对照组,2组患儿出生后1 min5、min、10 min给予Apgar评分;生后72 h行头颅CT检查;生后第3天、第14天行新生儿神经行为测定(NBNA)。结果观察组1 min Apgar评分、第3天NBNA评分明显低于对照组(t=-2.55,P=0.02;t=-2.31,P=0.03),5 min Apgar评分、10 min Apgar评分、第14天NBNA差异无统计学意义(t=1.45,P=0.16;t=0.04,P=0.97;t=-0.61,P=0.55)。观察组窒息率明显高于对照组(2χ=4.14,P=0.04),头颅CT异常率高于对照组(χ2=4.40,P=0.04),观察组在行为能力方面明显低于对照组(t=-2.31,P=0.03)。结论Ⅲ度羊水污染新生儿窒息明显高于其他胎儿窘迫患儿,脑损伤发生率高,早期护脑干预可减轻脑损伤程度。展开更多
文摘Background: Meconium stained amniotic fluid (MSAF) is frequently encountered in obstetric practice. Literature on the subject is still poorly documented in the African setting. Objective: The aim of this study was to determine the maternal and fetal outcomes in case of meconium stained amniotic fluid observed during term labour. Materials and Methods: We conducted a prospective cohort study enrolling all consenting pregnant women with term singleton fetus in cephalic presentation admitted for labour with ruptured fetal membranes in the maternity units of the Yaoundé Central Hospital (YCH) and the Yaoundé Gynaeco-Obstetric and Pediatric Hospital (YGOPH) of Cameroon between December 2014 and April 2015. The exposed grouped was considered as participants having MSAF, while the non-exposed group comprised those with clear amniotic fluid (CAF). The two groups were monitored during labor using the WHO partograph, and then followed up till 72 hours after delivery. Variables studied included the colour and texture of amniotic fluid as well as maternal and fetal complications. Data was analyzed using Epi-info version 3.5.4. The chi-square and Fischer’s exact tests were appropriately used to compare the two groups. A p-value less than 5% was considered statistically significant. Results: 2376 vaginal deliveries were recorded during the study period among which MSAF was observed in 265 cases, hence a prevalence rate of MSAF of 11.15%. Among these cases of MSAF, 52.1% was thick meconium and 47.9% was light meconium. Maternal morbidity was high in the group with MSAF;these included: Higher proportions of caesarean delivery (RR = 2.35 p -4) and prolonged labor (RR = 3 p -4). In this same group, the incidences of chorioamnionitis and puerperal sepsis were low (0.94% and 0.70% respectively), although there was a three-fold higher risk that was not statistically significant (RR = 3, P = 0.31). Fetal and neonatal outcomes were poorer in the MSAF group compared to the CAF group. The complications included fetal heart rate abnormalities, low Apgar score at the 5th minute, need for neonatal resuscitation, neonatal asphyxia and neonatal infection which were significantly higher in the MSAF group (all p < 0.05). Meconium aspiration syndrome (MAS) was found in 2.34% of MSAF cases. Perinatal mortality was 2.34% and all cases of death occurred in the thick MSAF group. Conclusion: MSAF observed during labour is associated with increased perinatal morbidity and mortality. Its detection during labor should strongly indicate very rigorous intra partum and postpartum monitoring. This will ensure optimal management and reduction in the risks of complications.
文摘Introduction: We examined the perinatal outcomes in Japanese singleton pregnancies associated with meconium-stained amniotic fluid (MSAF) in relation to gestational age at delivery. Methods: We reviewed the obstetric records of all Japanese singleton deliveries after 22 weeks’ gestation managed at Japanese Red Cross Katsushika Maternity Hospital between 2002 and 2008 (n = 11,249). Results: The incidence of MSAF in the whole singleton pregnancies was 13%. The incidence of MSAF at preterm, term and post-term were 9.1%, 13% and 48%, respectively. The incidence of intrauterine fetal death, low Apgar score and low umbilical artery pH at delivery in cases with MSAF were significantly higher than those without MSAF in various gestational ages at delivery. Conclusion: Obstetric management should be affected by meconium in the amniotic fluid.
文摘目的：探讨胎儿窘迫伴（或不伴）羊水粪染的新生儿脐血中8-异前列腺素（8-iso-PGF2α）水平的变化及其临床意义。方法：选取胎儿窘迫伴（或不伴）羊水粪染的新生儿152例,进行出生后1 min Apgar评分,按羊水粪染情况分为无粪染组36例和Ⅰ度粪染组38例、Ⅱ度粪染组39例、Ⅲ度粪染组39例,并选取同期正常新生儿38例为对照组。采用双抗体夹心酶联免疫法检测五组新生儿脐血8-iso-PGF2α水平并对结果进行分析。结果：（1）胎儿窘迫病情越严重,患儿血清8-iso-PGF2α水平越高,体内氧化应激反应越严重,特别是羊水粪染≥Ⅱ度时,患儿血清8-iso-PGF2α水平明显高于正常新生儿、无或Ⅰ度粪染患儿（P〈0.05）;（2）Apgar评分≤8分患儿血清8-iso-PGF2α水平高于正常新生儿及9~10分患儿（P〈0.05）;（3）以8-iso-PGF2α水平为检验变量,是否窘迫为状态变量,作ROC曲线分析,曲线下面积（AUC）为0.880,95%CI为0.835-0.901,以8-iso-PGF2α水平判断是否有胎儿窘迫的Cut-off值为4.23 ng/m L。结论：胎儿窘迫的发生发展与过氧化损伤有关,脐血8-iso-PGF2α水平能够准确反映胎儿窘迫羊水粪染新生儿过氧化损伤的程度,与Apgar评分能够共同作为及时预测新生儿缺血缺氧性脑病发生的指标。
文摘目的:分析胎粪污染羊水(MSAF)新生儿发生胎粪吸入综合征(MAS)的风险评估简表构建及预测效果。方法:收集2023年1月至2023年12月江西信丰县妇幼保健院收治的MSAF新生儿60例为研究对象,根据是否并发MAS分无MAS组、MAS组,回顾性收集两组患儿一般资料、实验室检查指标、母亲一般资料等进行分析。应用多因素Logistic回归分析MSAF新生儿发生MAS的危险因素,基于危险因素构建MSAF新生儿发生MAS的风险评估简表,并采用受试者特征曲线(ROC)验证该风险评估简表的预测效果。结果:本研究共纳入60例MSAF新生儿,发生MAS的患儿21例(35.00%);MAS组1 min阿普加(Apgar)评分、胎膜早破发生率、羊水过少、外周血白细胞(WBC)、降钙素原(PCT)较无MAS组明显高(P<0.05);MAS组酸碱值(pH值)、碱剩余(BE值)较无MAS组明显低(P<0.05)。经多因素Logistic回归分析示,羊水过少、pH值、WBC及1 min Apgar评分(4个)是MSAF新生儿发生MAS的独立危险因素(P<0.05)。依据Logistic回归分析结果构建胎粪污染羊水新生儿发生MAS的风险评估简表,ROC分析显示其预测MAS的曲线下面积为0.955(95%CI:0.920~0.974),敏感性为85.71%,特异性为92.31%。结论:MSAF新生儿发生MAS的独立危险因素有羊水过少、pH值、WBC及1 min Apgar评分,以此构建风险评估简表模型,预测效果显著。
文摘目的探讨Ⅲ度羊水污染对新生儿神经系统的影响。方法胎儿宫内窘迫患儿44例,其中Ⅲ度羊水污染20例作为观察组,其余24例患儿为对照组,2组患儿出生后1 min5、min、10 min给予Apgar评分;生后72 h行头颅CT检查;生后第3天、第14天行新生儿神经行为测定(NBNA)。结果观察组1 min Apgar评分、第3天NBNA评分明显低于对照组(t=-2.55,P=0.02;t=-2.31,P=0.03),5 min Apgar评分、10 min Apgar评分、第14天NBNA差异无统计学意义(t=1.45,P=0.16;t=0.04,P=0.97;t=-0.61,P=0.55)。观察组窒息率明显高于对照组(2χ=4.14,P=0.04),头颅CT异常率高于对照组(χ2=4.40,P=0.04),观察组在行为能力方面明显低于对照组(t=-2.31,P=0.03)。结论Ⅲ度羊水污染新生儿窒息明显高于其他胎儿窘迫患儿,脑损伤发生率高,早期护脑干预可减轻脑损伤程度。
