AIM To compare the outcome between patients with jejunoileal atresia(JIA) associated with cystic meconium peritonitis(CMP) and patients with isolated JIA(JIA without CMP).METHODS A retrospective study was conducted fo...AIM To compare the outcome between patients with jejunoileal atresia(JIA) associated with cystic meconium peritonitis(CMP) and patients with isolated JIA(JIA without CMP).METHODS A retrospective study was conducted for all neonates with JIA operated in our institute from January 2005 to January 2016.Demographics including the gestation age,sex,birth weight,age at operation,the presence of associated syndrome was recorded.Clinical outcome including the type of operation performed,operative time,the need for reoperation and mortality were studied.The demographics and the outcome between the 2 groups were compared.RESULTS During the study period,53 neonates had JIA underwent operation in our institute.Seventeen neonates(32%) were associated with CMP.There was no statistical difference on the demographics in the two groups.Patients with CMP had earlier operation than patients with isolated JIA(mean 1.4 d vs 3 d,P = 0.038).Primaryanastomosis was performed in 16 patients(94%) with CMP and 30 patients(83%) with isolated JIA(P = 0.269).Patients with CMP had longer operation(mean 190 min vs 154 min,P = 0.004).There were no statistical difference the need for reoperation(3 vs 6,P = 0.606) and mortality(2 vs 1,P = 0.269) between the two groups.CONCLUSION Primary intestinal anastomosis can be performed in94% of patients with JIA associated with CMP.Although patients with CMP had longer operative time,the mortality and reoperation rates were low and were comparable to patients with isolated JIA.展开更多
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
Background and objectives: In prior studies we demonstrated that meconium-induced lung cell death by apoptosis was associated with activation of the local pulmonary renin-angiotensin system (RASL). Alveolar epithelial...Background and objectives: In prior studies we demonstrated that meconium-induced lung cell death by apoptosis was associated with activation of the local pulmonary renin-angiotensin system (RASL). Alveolar epithelial apoptosis requires the authocrine synthesis and proteolytic processing of angiotensinogen (AGT) to Angiotensin II (ANG II). Inhibitors of angiotensin converting enzyme (ACE) block meconium-induced apoptosis. ANG II plays an essential role in vascular homeostasis and lung injury. The objectives of this study were to evaluate expression of AGT, ANG II and Caspase 3 in meconium and saline treated newborn lungs and to study mechanisms of its inhibition by a selective antagonist of the AT1 receptor. Methods: Two week old rabbits were studied. Three treatment groups were studied (six rabbit pups in each group): Group 1: rabbits instilled with saline;Group 2: rabbits instilled with 10% meconium;Group 3: Losartan pretreated followed by meconium-instillation. Three groups of A549 human lung epithelial cells were studies as well. Group 4: AGT pretreated and then meconium-exposed cells;Group 5: ANG II pretreated and then meconium exposed cells and Group 6: Caspase 3 inhibitor ZVAD-fmk pretreated and then meconium exposed cells. AGT, ANG II and Caspase 3 were evaluated and compared with and without inhibitors in meconium and control groups. Results: In Situ End Labeling (ISEL) and Caspase 3 assays showed that purified ANG II induced dose dependent apoptosis in rabbit lung lavage cells and the human A549 lung epithelial cell line. Apoptosis also was induced by purified AGT. The increase in apoptotic cells was accompanied by increases in ANG II and Caspase 3 activities. In both airway epithelium and alveolar wall cells, measures of apoptosis were attenuated by Losartan or by the Caspase 3 inhibitor ZVAD-fmk. Conclusions: These data demonstrate the presence of a functional ANG II and Caspase 3 dependent apoptotic pathways in newborn meconium-instilled lungs. They also imply that meconium-induced apoptosis is modulated by the pulmonary RASL system in which ANG II plays a critical role. Both losartan and the Caspase 3 inhibitor ZVAD-fmk pretreatment significantly decreased meconium-induced Caspase-3 activation and lung cell apoptosis.展开更多
We demonstrated previously that inflammatory cy-tokines TNF, IL-1, IL-6 and IL-8 are signifi-cantly expressed in meconium-instilled lungs. Capto-pril was a strong inhibitor of meconium-induced lung injury, inflammatio...We demonstrated previously that inflammatory cy-tokines TNF, IL-1, IL-6 and IL-8 are signifi-cantly expressed in meconium-instilled lungs. Capto-pril was a strong inhibitor of meconium-induced lung injury, inflammation and apoptosis and reduces lung alveolar and airway epithelial cell damage. Presently we demonstrate that IL-13 expression in the me-conium aspiration syndrome (MAS). IL-13 was maximally expressed 8 hrs after meconium instilla-tion. It was previously described that IL-13 plays a major role in degradation of airway epithelial cells and inducing of lung fibrosis by activating collagen production that is a major point in identification of lung fibrosis. We also showed that Captopril treat-ment significantly inhibits IL-13 expression in the lungs. We believe it reduces meconium-induced lung injury and has a therapeutic effect on histological and biochemical functions of the lungs and possibly pulmonary fibrosis. Captopril treatment significantly reduced the number of neuprophils and macrophages which express IL13 and levels of other inflammatory cytokines after meconium instillation. Selective neu-tralization of IL-13 ameliorated lung injury, airway hyper responsiveness, eosinophil recruitment and mucus overproduction.展开更多
Laryngoscopy is a medical procedure that provides a secure airway by passing a breathing tube through the mouth and into the lungs of a patient, and to perform meconium suction in newborns to avoid asphyxia. The abili...Laryngoscopy is a medical procedure that provides a secure airway by passing a breathing tube through the mouth and into the lungs of a patient, and to perform meconium suction in newborns to avoid asphyxia. The ability to successfully perform meconium suction is highly dependent on operator skill and the availability of trained assistants to assist during the procedure. The immediate objective of this research paper is to present an improved device, so that the procedure can be performed at a faster pace and the need for assistants is eliminated. Experienced physicians have used the device presented in the paper on mannequin, and the operating time and ease were observed to have improved.展开更多
<strong>Background:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> Meconium aspiration syndrome (MAS) in the newborn is characte...<strong>Background:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> Meconium aspiration syndrome (MAS) in the newborn is characterized by hypoxia, hypercapnia, and acidosis. MAS is a leading cause of morbidity and mortality in neonates. The primary objective of this study was to estimate the frequency of meconium aspiration syndrome (MAP) in babies born with meconium-stained liquor. The secondary outcome was to estimate the meconium aspiration syndrome;in terms of hospital stay, complications, and mortality. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">The study was done at Aga Khan Maternal and Child Care Centre, Hyderabad, Pakistan. Study design was case series and the duration of the study was of 6 months. All patients who fulfilled the inclusion criteria were included in the study after taking informed written consent. A brief history was taken, clinical examination was done and laboratory investigations were sent to the institutional laboratory. Study outcomes were measured from this data </span><i><span style="font-family:Verdana;">i</span></i><span style="font-family:Verdana;">.</span><i><span style="font-family:Verdana;">e</span></i><span style="font-family:Verdana;">. MAS, its complications, mortality, and a number of days in the hospital. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">A total of 87 babies</span><b><i> </i></b><span style="font-family:Verdana;">born with meconium-stained liquor at secondary care hospital were included. A total of 45 patients (52%) were males and 42 patients (48%) were females with a mean gestational age of babies 38.896 </span></span><span style="font-family:;" "=""><span style="font-family:Verdana;">± </span><span style="font-family:Verdana;">1.210 weeks. The mean Apgar score at 5 minutes was 8.896 </span><span style="font-family:Verdana;">± </span><span><span style="font-family:Verdana;">0.404. MAS was present in 13 patients (14.9%). Complications </span><span><span style="font-family:Verdana;">were seen only one patient (1.1%) and there was no neonatal death reported. </span><b><span style="font-family:Verdana;">Discussion: </span></b><span style="font-family:Verdana;">MAS</span><b> </b><span style="font-family:Verdana;">was present in 14.9% of babies;the complication of subacute bacterial infection was low seen in just 1.1% cases with no neonatal</span></span><span style="font-family:Verdana;"> mortality.</span></span></span>展开更多
<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Meconium stained amniotic fluid (MSAF), especially o...<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Meconium stained amniotic fluid (MSAF), especially observed before term, is considered a sign of fetal jeopardy. Although many studies characterized this condition and associated it with delivery mode, data is lacking in this area, Saudi Arabia. Thus, we attempted to study it. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> All data were retrieved from pregnant patients with MSAF who delivered at King Abdul, Saudi Arabia, from January 2015 to December 2018. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> 758 showed MSAF, of which 83% had vaginal delivery, whereas remaining 17% had an emergency caesarean section. Of them, 32 (4.2%) infants developed meconium aspiration syndrome, and 7 (21.8%) were admitted to the NICU. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> It was reconfirmed that MSAF is associated with a newborn risk, especially meconium aspiration syndrome. Patients had a higher rate for emergent caesarean section and baby admission to NICU. These data may be useful to make health/reproductive-health poly-making in this area.</span></span></span></span>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
Objective To investigate the factors in relation with the case fatality in severe meconium aspiration syndrome (MAS). Methods Eighty-one severe MAS cases intervened by the mechanical ventilation from 9 childrens hospi...Objective To investigate the factors in relation with the case fatality in severe meconium aspiration syndrome (MAS). Methods Eighty-one severe MAS cases intervened by the mechanical ventilation from 9 childrens hospitals were retrospectively analyzed for the risk factors of fatality with SAS software for non-parametric rank sum test and chi-square test. Results In the 81 cases, 49 were survived (death rate 39%). The gestational age (GA), Apgars score at 1min and other complications with MAS were significantly related to the death (P <0.05). There was no difference of death rate between the patients with or without receiving endotracheal intubation and airway suctioning (P>0.05). Conclusion A higher death rate (close to 40%) of severe MAS in the middle of 1990s in major cities of China suggests that it is important to detect the intrauterine hypoxemia as it may indicated by meconium staining amniotic fluid which should be intervened early by adequate termination of pregnancy before 42 weeks. The effects of delivery room suction and conventional ventilation also need to be reevaluated.展开更多
The Meconial Aspiration Syndrome (MAS) is a complication caused by the presence of meconium amniotic fluid with consequent aspiration, being responsible for important rates of perinatal morbidity and mortality. This s...The Meconial Aspiration Syndrome (MAS) is a complication caused by the presence of meconium amniotic fluid with consequent aspiration, being responsible for important rates of perinatal morbidity and mortality. This study aims to analyze the bibliographical production on newborn care with meconium elimination in the delivery room. It was a literature integrative review electronically based. Most of the studies referred to tracheal intubation and exogenous surfactant ministration as main care methods. The Meconium Aspiration Syndrome is presented as main theme. It is understood that health care professionals must develop knowledge, skills and actions, showing conduct based on scientific, critical and reflexive knowledge with purposeful interventions directed to the patient’s needs.展开更多
Background Making decisions regarding the mode of delivery in the cases of meconium amniotic fluid(MAF)presents a challenge for healthcare providers.We aimed to compare the neonatal outcome of MAF cases delivered via ...Background Making decisions regarding the mode of delivery in the cases of meconium amniotic fluid(MAF)presents a challenge for healthcare providers.We aimed to compare the neonatal outcome of MAF cases delivered via cesarean section(CS)versus those delivered vaginally to determine if CS is a protective factor against the adverse neonatal outcomes.Methods In this retrospective study,we assessed singleton pregnant mothers diagnosed with MAF who gave birth at a tertiary hospital in Bandar Abbas,Iran,between January 2020-2022.Mothers with certain adverse pregnancy conditions were excluded from the study.These conditions included:abnormal fetal heart rate and pattern,bloody amniotic fluid,malpresentation,abnormal placentation,chorioamnionitis,intrauterine growth restriction,intrauterine fetal death,obstructed labor,and maternal comorbidities.The MAF mothers were divided into two groups based on the method of delivery:those who had CS and those who had a normal vaginal delivery(NVD).Demographic factors,obstetrical factors,and neonatal outcomes were compared between the two groups.Results Out of 746 MAF mothers,213(28.5%)underwent CS,while 533(71.4%)had NVD.There were no significant differences between the groups in terms of demographic characteristics.Among MAF mothers who had CS,66.2%were primiparous,and 33.8%were multiparous.For those who had NVD,35.1%were primiparous,and 64.9%were multiparous.The first and 5-min Apgar values,rates of asphyxia,neonatal intensive care unit(NICU)admission,and neonatal death were not statistically different between the two delivery modes.The rate of newborns who breastfed within the first hour did not differ depending on the mode of delivery.Although initial resuscitation steps were required more frequently in MAF mothers with NVD than in those with CS(11.1%vs.2.3%),no correlation was found between the mode of delivery and the need for resuscitation using logistic regression.Conclusions Our research findings suggest that there were no superior neonatal outcomes in terms of CS compared to NVD in MAF mothers.Further studies are needed to provide more substantial evidence to support this conclusion.展开更多
文摘AIM To compare the outcome between patients with jejunoileal atresia(JIA) associated with cystic meconium peritonitis(CMP) and patients with isolated JIA(JIA without CMP).METHODS A retrospective study was conducted for all neonates with JIA operated in our institute from January 2005 to January 2016.Demographics including the gestation age,sex,birth weight,age at operation,the presence of associated syndrome was recorded.Clinical outcome including the type of operation performed,operative time,the need for reoperation and mortality were studied.The demographics and the outcome between the 2 groups were compared.RESULTS During the study period,53 neonates had JIA underwent operation in our institute.Seventeen neonates(32%) were associated with CMP.There was no statistical difference on the demographics in the two groups.Patients with CMP had earlier operation than patients with isolated JIA(mean 1.4 d vs 3 d,P = 0.038).Primaryanastomosis was performed in 16 patients(94%) with CMP and 30 patients(83%) with isolated JIA(P = 0.269).Patients with CMP had longer operation(mean 190 min vs 154 min,P = 0.004).There were no statistical difference the need for reoperation(3 vs 6,P = 0.606) and mortality(2 vs 1,P = 0.269) between the two groups.CONCLUSION Primary intestinal anastomosis can be performed in94% of patients with JIA associated with CMP.Although patients with CMP had longer operative time,the mortality and reoperation rates were low and were comparable to patients with isolated JIA.
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Background and objectives: In prior studies we demonstrated that meconium-induced lung cell death by apoptosis was associated with activation of the local pulmonary renin-angiotensin system (RASL). Alveolar epithelial apoptosis requires the authocrine synthesis and proteolytic processing of angiotensinogen (AGT) to Angiotensin II (ANG II). Inhibitors of angiotensin converting enzyme (ACE) block meconium-induced apoptosis. ANG II plays an essential role in vascular homeostasis and lung injury. The objectives of this study were to evaluate expression of AGT, ANG II and Caspase 3 in meconium and saline treated newborn lungs and to study mechanisms of its inhibition by a selective antagonist of the AT1 receptor. Methods: Two week old rabbits were studied. Three treatment groups were studied (six rabbit pups in each group): Group 1: rabbits instilled with saline;Group 2: rabbits instilled with 10% meconium;Group 3: Losartan pretreated followed by meconium-instillation. Three groups of A549 human lung epithelial cells were studies as well. Group 4: AGT pretreated and then meconium-exposed cells;Group 5: ANG II pretreated and then meconium exposed cells and Group 6: Caspase 3 inhibitor ZVAD-fmk pretreated and then meconium exposed cells. AGT, ANG II and Caspase 3 were evaluated and compared with and without inhibitors in meconium and control groups. Results: In Situ End Labeling (ISEL) and Caspase 3 assays showed that purified ANG II induced dose dependent apoptosis in rabbit lung lavage cells and the human A549 lung epithelial cell line. Apoptosis also was induced by purified AGT. The increase in apoptotic cells was accompanied by increases in ANG II and Caspase 3 activities. In both airway epithelium and alveolar wall cells, measures of apoptosis were attenuated by Losartan or by the Caspase 3 inhibitor ZVAD-fmk. Conclusions: These data demonstrate the presence of a functional ANG II and Caspase 3 dependent apoptotic pathways in newborn meconium-instilled lungs. They also imply that meconium-induced apoptosis is modulated by the pulmonary RASL system in which ANG II plays a critical role. Both losartan and the Caspase 3 inhibitor ZVAD-fmk pretreatment significantly decreased meconium-induced Caspase-3 activation and lung cell apoptosis.
文摘We demonstrated previously that inflammatory cy-tokines TNF, IL-1, IL-6 and IL-8 are signifi-cantly expressed in meconium-instilled lungs. Capto-pril was a strong inhibitor of meconium-induced lung injury, inflammation and apoptosis and reduces lung alveolar and airway epithelial cell damage. Presently we demonstrate that IL-13 expression in the me-conium aspiration syndrome (MAS). IL-13 was maximally expressed 8 hrs after meconium instilla-tion. It was previously described that IL-13 plays a major role in degradation of airway epithelial cells and inducing of lung fibrosis by activating collagen production that is a major point in identification of lung fibrosis. We also showed that Captopril treat-ment significantly inhibits IL-13 expression in the lungs. We believe it reduces meconium-induced lung injury and has a therapeutic effect on histological and biochemical functions of the lungs and possibly pulmonary fibrosis. Captopril treatment significantly reduced the number of neuprophils and macrophages which express IL13 and levels of other inflammatory cytokines after meconium instillation. Selective neu-tralization of IL-13 ameliorated lung injury, airway hyper responsiveness, eosinophil recruitment and mucus overproduction.
文摘Laryngoscopy is a medical procedure that provides a secure airway by passing a breathing tube through the mouth and into the lungs of a patient, and to perform meconium suction in newborns to avoid asphyxia. The ability to successfully perform meconium suction is highly dependent on operator skill and the availability of trained assistants to assist during the procedure. The immediate objective of this research paper is to present an improved device, so that the procedure can be performed at a faster pace and the need for assistants is eliminated. Experienced physicians have used the device presented in the paper on mannequin, and the operating time and ease were observed to have improved.
文摘<strong>Background:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> Meconium aspiration syndrome (MAS) in the newborn is characterized by hypoxia, hypercapnia, and acidosis. MAS is a leading cause of morbidity and mortality in neonates. The primary objective of this study was to estimate the frequency of meconium aspiration syndrome (MAP) in babies born with meconium-stained liquor. The secondary outcome was to estimate the meconium aspiration syndrome;in terms of hospital stay, complications, and mortality. </span><b><span style="font-family:Verdana;">Methods: </span></b><span style="font-family:Verdana;">The study was done at Aga Khan Maternal and Child Care Centre, Hyderabad, Pakistan. Study design was case series and the duration of the study was of 6 months. All patients who fulfilled the inclusion criteria were included in the study after taking informed written consent. A brief history was taken, clinical examination was done and laboratory investigations were sent to the institutional laboratory. Study outcomes were measured from this data </span><i><span style="font-family:Verdana;">i</span></i><span style="font-family:Verdana;">.</span><i><span style="font-family:Verdana;">e</span></i><span style="font-family:Verdana;">. MAS, its complications, mortality, and a number of days in the hospital. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">A total of 87 babies</span><b><i> </i></b><span style="font-family:Verdana;">born with meconium-stained liquor at secondary care hospital were included. A total of 45 patients (52%) were males and 42 patients (48%) were females with a mean gestational age of babies 38.896 </span></span><span style="font-family:;" "=""><span style="font-family:Verdana;">± </span><span style="font-family:Verdana;">1.210 weeks. The mean Apgar score at 5 minutes was 8.896 </span><span style="font-family:Verdana;">± </span><span><span style="font-family:Verdana;">0.404. MAS was present in 13 patients (14.9%). Complications </span><span><span style="font-family:Verdana;">were seen only one patient (1.1%) and there was no neonatal death reported. </span><b><span style="font-family:Verdana;">Discussion: </span></b><span style="font-family:Verdana;">MAS</span><b> </b><span style="font-family:Verdana;">was present in 14.9% of babies;the complication of subacute bacterial infection was low seen in just 1.1% cases with no neonatal</span></span><span style="font-family:Verdana;"> mortality.</span></span></span>
文摘<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Meconium stained amniotic fluid (MSAF), especially observed before term, is considered a sign of fetal jeopardy. Although many studies characterized this condition and associated it with delivery mode, data is lacking in this area, Saudi Arabia. Thus, we attempted to study it. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> All data were retrieved from pregnant patients with MSAF who delivered at King Abdul, Saudi Arabia, from January 2015 to December 2018. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> 758 showed MSAF, of which 83% had vaginal delivery, whereas remaining 17% had an emergency caesarean section. Of them, 32 (4.2%) infants developed meconium aspiration syndrome, and 7 (21.8%) were admitted to the NICU. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> It was reconfirmed that MSAF is associated with a newborn risk, especially meconium aspiration syndrome. Patients had a higher rate for emergent caesarean section and baby admission to NICU. These data may be useful to make health/reproductive-health poly-making in this area.</span></span></span></span>
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Objective To investigate the factors in relation with the case fatality in severe meconium aspiration syndrome (MAS). Methods Eighty-one severe MAS cases intervened by the mechanical ventilation from 9 childrens hospitals were retrospectively analyzed for the risk factors of fatality with SAS software for non-parametric rank sum test and chi-square test. Results In the 81 cases, 49 were survived (death rate 39%). The gestational age (GA), Apgars score at 1min and other complications with MAS were significantly related to the death (P <0.05). There was no difference of death rate between the patients with or without receiving endotracheal intubation and airway suctioning (P>0.05). Conclusion A higher death rate (close to 40%) of severe MAS in the middle of 1990s in major cities of China suggests that it is important to detect the intrauterine hypoxemia as it may indicated by meconium staining amniotic fluid which should be intervened early by adequate termination of pregnancy before 42 weeks. The effects of delivery room suction and conventional ventilation also need to be reevaluated.
文摘The Meconial Aspiration Syndrome (MAS) is a complication caused by the presence of meconium amniotic fluid with consequent aspiration, being responsible for important rates of perinatal morbidity and mortality. This study aims to analyze the bibliographical production on newborn care with meconium elimination in the delivery room. It was a literature integrative review electronically based. Most of the studies referred to tracheal intubation and exogenous surfactant ministration as main care methods. The Meconium Aspiration Syndrome is presented as main theme. It is understood that health care professionals must develop knowledge, skills and actions, showing conduct based on scientific, critical and reflexive knowledge with purposeful interventions directed to the patient’s needs.
文摘Background Making decisions regarding the mode of delivery in the cases of meconium amniotic fluid(MAF)presents a challenge for healthcare providers.We aimed to compare the neonatal outcome of MAF cases delivered via cesarean section(CS)versus those delivered vaginally to determine if CS is a protective factor against the adverse neonatal outcomes.Methods In this retrospective study,we assessed singleton pregnant mothers diagnosed with MAF who gave birth at a tertiary hospital in Bandar Abbas,Iran,between January 2020-2022.Mothers with certain adverse pregnancy conditions were excluded from the study.These conditions included:abnormal fetal heart rate and pattern,bloody amniotic fluid,malpresentation,abnormal placentation,chorioamnionitis,intrauterine growth restriction,intrauterine fetal death,obstructed labor,and maternal comorbidities.The MAF mothers were divided into two groups based on the method of delivery:those who had CS and those who had a normal vaginal delivery(NVD).Demographic factors,obstetrical factors,and neonatal outcomes were compared between the two groups.Results Out of 746 MAF mothers,213(28.5%)underwent CS,while 533(71.4%)had NVD.There were no significant differences between the groups in terms of demographic characteristics.Among MAF mothers who had CS,66.2%were primiparous,and 33.8%were multiparous.For those who had NVD,35.1%were primiparous,and 64.9%were multiparous.The first and 5-min Apgar values,rates of asphyxia,neonatal intensive care unit(NICU)admission,and neonatal death were not statistically different between the two delivery modes.The rate of newborns who breastfed within the first hour did not differ depending on the mode of delivery.Although initial resuscitation steps were required more frequently in MAF mothers with NVD than in those with CS(11.1%vs.2.3%),no correlation was found between the mode of delivery and the need for resuscitation using logistic regression.Conclusions Our research findings suggest that there were no superior neonatal outcomes in terms of CS compared to NVD in MAF mothers.Further studies are needed to provide more substantial evidence to support this conclusion.
