Meconium-stained amniotic fluid: a risk factor for postpartum hemorrhage

Bouchè, C; Wiesenfeld, Uri; Ronfani, Luca; Simeone, Roberto; Bogatti, P.; Skerk, Kristina; Ricci, Giuseppe

doi:10.2147/tcrm.s150049

Cited by 7 publications

(5 citation statements)

References 44 publications

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“…The rate of meconium‐stained amniotic fluid was higher in the amnioinfusion group compared with the control group. Meconium‐stained amniotic fluid is considered a marker of fetal distress 23 and has been associated with increased risk of various adverse maternal and neonatal outcomes including non‐reassuring fetal heart rate, cesarean delivery, postpartum hemorrhage, low Apgar scores, and meconium aspiration syndrome 24,25 . As no differences in the rate of maternal or neonatal complications were found, the results from the present study further strengthen the assumption that amnioinfusion after diagnosis of SII is safe.…”

Section: Discussionsupporting

confidence: 78%

Is it safe to perform amnioinfusion in the presence of suspected intraamniotic infection?

Meyer

Rottenstreich

Tsur

et al. 2020

Intl J Gynecology & Obste

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Objective: To study the effect of amnioinfusion in the presence of suspected intraamniotic infections (SII) on maternal outcomes among women delivering at term. Methods: A retrospective cohort study was conducted at a tertiary medical center. All consecutive singleton term deliveries with SII during 2011-2019 were included. Cases where amnioinfusion was performed after the diagnosis of SII were compared to cases without amnioinfusion, matched by cervical dilation at diagnosis of SII. Maternal and obstetric adverse outcomes were compared. Results: After matching for cervical dilation at diagnosis of SII, the study cohort included 786 women: 62 (7.9%) women in the amnioinfusion group and 724 (92.1%) in the control group. A composite of adverse maternal outcomes occurred in 106 (13.5%) deliveries. There were no significant differences in the rates of maternal adverse outcomes between the amnioinfusion and control groups (11.0% vs 13.7%, respectively; P=0.59), including postpartum endometritis (5.0% vs 3.3%, respectively; P=0.46) and febrile morbidity (10.0% vs 6.5%, respectively; P=0.42). Neonatal blood gas outcomes and Apgar scores did not differ between groups. Conclusion: The use of amnioinfusion for alleviating non-reassuring fetal heart rate in the presence of SII is safe and does not increase the rate of maternal adverse outcome.

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Section: Discussionsupporting

confidence: 78%

Is it safe to perform amnioinfusion in the presence of suspected intraamniotic infection?

Meyer

Rottenstreich

Tsur

et al. 2020

Intl J Gynecology & Obste

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“…It stated that meconium stained amniotic fluid is associated with increased risk of postpartum hemorrhage than clear amniotic fluid. 11 In our study no such relation was studied. A study conducted in Switzerland also stated increased incidence of PPH in recent years and associated with decreased tone of uterus which is its main cause.…”

Section: Discussionmentioning

confidence: 78%

Chronic vaginal discharge; presentation and management among women of underdeveloped areas.

Rehman¹,

Zafar

Gulbaz

2020

TPMJ

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Objectives: To determine various presentations of patients with chronic vaginal discharge belonging to underdeveloped areas and its response to management. Study Design: Cross sectional study. Setting: Rai Medical College, Doctors Trust Teaching Hospital Sargoodha. Period: 07 months from July to December 2018. Material & Methods: This study was conducted in Obstetric and Gynaecology unit of study institution. Total 150 cases were included in this study belonging to underdeveloped areas around Sargodha city presenting with vaginal discharge for more than 6 months duration. These cases were reported in outpatient door of gynae unit. Ages of these cases were 18-45 years. Patients with pregnancy, abnormal vagina or cervix and having growth of cervix were not included in this study. Permission was obtained from all cases for including them in this study. All data collected was analyzed in Microsoft office and version 2018 and expressed via tables and graphs. Results: Total 160 cases were included in this study presenting with the history of vaginal discharge with more than 6 months history. Their age range was 18-45 years with mean age of 35 years. Presenting complaints in study group were vaginal discharge in all (100%) cases, lower back pain in 53(33%), lower abdominal pain in 41(25.6%), itching in 38(23.8%), dysuria reported in 25(15.6%), dysparunia in 21(13%) cases and post coital bleeding reported in 18(11.3%) cases. Mean parity of cases in study group was 3±1. Vaginal infection was resolved in 70% cases after treatment with first line antibiotics and recovery rate increased up to 90% after treatment with 2nd line antibiotics. Various side effects of drugs were reported in study group. Most common side effects were anorexia in 9.4% cases, nausea in 7% and abdominal discomfort was reported in 5.6% cases. Conclusion: There is very high rate of sexual transmitted diseases among women living in peripheral under developed areas due to lack of proper awareness and high illiteracy rate among women. WHO recommended Symptomatic management is very effective in these cases.

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“…In addition, our results showed that in women with thick MSAF in the first stage of labor, the 24-hour vaginal bleeding volume was greater than that in women with thin MSAF, but the rate of PPH was not significantly different (data not shown). Previously published literature revealed that MSAF is significantly associated with a higher risk of moderate (1000–2000 mL) and severe (>2000 mL) PPH than clear AF, 18 but another study reported the risk is higher for minor (500–1000 mL) and moderate but not for severe PPH, 19 a finding which may need further studies. Regarding puerperal infections, our results showed only a slight change in WBC count, CRP and neutrophil percentage or count, and no cases of puerperal infection or death existed in our data, which may be due to the use of antibiotics.…”

Section: Discussionmentioning

confidence: 92%

Once We Find Grade III Meconium Stained Amniotic Fluid, Must We Act as Early as Possible?

Zhu

Huang

Tang

et al. 2023

IJWH

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Background: Grade III meconium stained amniotic fluid (MSAF) is a common obstetric disease, and has the greatest impact on poor maternal and neonatal outcomes. Question or Hypothesis or Aim:There is no consensus on treatment, especially on the timing of delivery. Methods: We collected the medical records of 345 women who gave birth with grade III MSAF and analyzed the difference in baseline characteristics and maternal and neonatal outcomes relative to different labor stage, observation times in the first stage of labor, and the presence or absence of abnormal fetal heart rate (FHR) or thick amniotic fluid. Findings: Higher rate of cesarean section was observed when grade III MSAF was found in active labor. Intervention occurred at an observation time of 90-120 min, but there were no significant differences in maternal or neonatal outcomes shown when the observation time was greater than 3 or 4 hours. However, a higher rate of admission to the neonatal intensive care unit was demonstrated in cases with grade III MSAF with abnormal FHR either in the first or second stage of labor or in cases with thick MSAF in the second stage of labor. Discussion: Higher rate of composite adverse neonatal outcomes was found when secondary MSAF (a transition from clear AF to MSAF) was diagnosed >3 h before delivery. Conclusion:In the first stage of labor, an observation time of greater than 4 hours might be possible after grade III MSAF is found if the labor has progressed and is without abnormal FHR.

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Meconium-stained amniotic fluid: a risk factor for postpartum hemorrhage

Cited by 7 publications

References 44 publications

Is it safe to perform amnioinfusion in the presence of suspected intraamniotic infection?

Is it safe to perform amnioinfusion in the presence of suspected intraamniotic infection?

Chronic vaginal discharge; presentation and management among women of underdeveloped areas.

Once We Find Grade III Meconium Stained Amniotic Fluid, Must We Act as Early as Possible?

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