Document Type : Original Article

Authors

1 Department of Obstetrics and Gynecology, Preventative Gynecology Research Center, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Department of Obstetrics and Gynecology, Medicinal Plants Research Center, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran

3 Department of Obstetrics and Gynecology, Clinical Research Development Center, Kermanshah University of Medical Sciences, Kermanshah, Iran

Abstract

Meconium-stained amniotic fluid (MSAF) affects 15-20% of term pregnancies. Recent studies have shown that MSAF has adverse effects on neonatal outcomes. There is no scientific consensus on the incidence of fetal distress in MSAF neonates, and most cesarean sections due to MSAF are unnecessary. The present study was conducted to assess umbilical artery blood pH in neonates with MSAF and to examine whether there is a relationship between MSAF and fetal distress. A clinical survey case-control was conducted on the neonates of 200 pregnant women admitted to a delivery unit of the obstetrics and Gynecology center in Amir al-Momenin Hospital, Zabol in 2014. Neonates born with MSAF made up the case group, and the control group consisted of neonates born with clear amniotic fluid. Umbilical cord arterial pH, gestational age, gender, mode of delivery, and one and five-minute Apgar scores were considered in both groups. The mean pH of the umbilical cord artery blood in the infants of the case group was 7.25, and the mean pH of the umbilical cord artery in the infants of the control group was 7.29 (P = 0.93). The mean gestational age in the case and control groups was 40.08 weeks and 38.32 weeks, respectively (P= 0.03). In this study, a cesarean delivery (P=0.001) and female gender (P= 0.016) were higher in the case group than in the control group. MSAF does not necessarily imply fetal distress, so urgent cesarean sections are unnecessary. This study showed that based on the acidity variables of the umbilical cord artery, there is no statistically significant correlation between the Apgar score at the 1st and 5th minute. While a significant difference has been observed between the type of delivery, gestational age and baby's gender.

Graphical Abstract

The comparison of umbilical cord artery pH in newborns with and without thick meconium stained amniotic fluid

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ِDr. Nooshin Amjadi
Shahid Beheshti University of Medical Sciences

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  1. Kalra V, Leegwater AJ, Vadlaputi P, Garlapati P, Chawla S, Lakshminrusimha S (2022) Neonatal outcomes of non-vigorous neonates with meconium-stained amniotic fluid before and after change in tracheal suctioning recommendation. Journal of Perinatology 42 (6): 769-774. doi: https://doi.org/10.1038/s41372-021-01287-0
  2. Parween S, Prasad D, Poonam P, Ahmar R, Sinha A, Ranjana R, RANJANA R (2022) Impact of meconium-stained amniotic fluid on neonatal outcome in a tertiary hospital. Cureus 14 (4): e24464. doi: https://doi.org/10.7759/cureus.24464
  3. Phattraprayoon N, Tangamornsuksan W, Ungtrakul T (2021) Outcomes of endotracheal suctioning in non-vigorous neonates born through meconium-stained amniotic fluid: a systematic review and meta-analysis. Archives of Disease in Childhood-Fetal and Neonatal Edition 106 (1): 31-38. doi: http://dx.doi.org/10.1136/archdischild-2020-318941
  4. Strand M, Perlman JM Contemporary management of infants born through meconium stained amniotic fluid. In: Seminars in Perinatology, 2022. Elsevier, p 151625. doi: https://doi.org/10.1016/j.semperi.2022.151625
  5. Gelfand SL, Fanaroff JM, Walsh MC (2004) Meconium stained fluid: approach to the mother and the baby. Pediatric Clinics 51 (3): 655-667. doi: https://doi.org/10.1016/j.pcl.2004.01.012
  6. Ahanya SN, Lakshmanan J, Morgan BL, Ross MG (2005) Meconium passage in utero: mechanisms, consequences, and management. Obstetrical & gynecological survey 60 (1): 45-56. doi: https://doi.org/10.1097/01.ogx.0000149659.89530.c2
  7. Alchalabi AA-H, E. El-Sunna, F. Zayed, Lf Badria, A. Obeidat2, H (1999) Meconium-stained amniotic fluid in term pregnancies-a clinical view. Journal of Obstetrics and Gynaecology 19 (3): 262-264. doi: https://doi.org/10.1080/01443619965020
  8. Sharbaf FR, Amjadi N, Alavi A, Akbari S, Forghani F (2014) Normal and indeterminate pattern of fetal cardiotocography in admission test and pregnancy outcome. Journal of Obstetrics and Gynaecology Research 40 (3): 694-699. doi: https://doi.org/10.1111/jog.12226
  9. Neilson JP (2015) Fetal electrocardiogram (ECG) for fetal monitoring during labour. Cochrane database of systematic reviews(12). doi: https://doi.org/10.1002/14651858.CD000116.pub5
  10. Vandenbussche FP, Oepkes D, Keirse MJ (1999) The merit of routine cord blood pH measurement at birth. 27 (3): 158-165. doi: https://doi.org/10.1515/JPM.1999.021
  11. Brouillette RT, Waxman DH (1997) Evaluation of the newborn’s blood gas status. Clinical Chemistry 43 (1): 215-221. doi: https://doi.org/10.1093/clinchem/43.1.215
  12. Monfredini C, Cavallin F, Villani PE, Paterlini G, Allais B, Trevisanuto D (2021) Meconium aspiration syndrome: a narrative review. Children 8 (3): 230. doi: https://doi.org/10.3390/children8030230
  13. Hızlı D, Altınbaş ŞK, Köşüş N, Köşüş A, Ayyıldız A, Gelişen O, Kafalı H (2013) Is meconium stained amniotic fluid related to occult myocardial injury in term low risk pregnancies? Early Human Development 89 (3): 191-194. doi: https://doi.org/10.1016/j.earlhumdev.2012.10.002
  14. Tayade S (2012) The significance of meconium stained amniotic fluid-a cross sectional study in a rural setup. IJBAR 3 (12): 861-866. doi: https://doi.org/10.7439/ijbar.v3i12.838
  15. Mundhra R, Agarwal M (2013) Fetal outcome in meconium stained deliveries. Journal of clinical and diagnostic research: JCDR 7 (12): 2874. doi: https://doi.org/10.7860%2FJCDR%2F2013%2F6509.3781
  16. Lee KA, Mi lee S, Jin Yang H, Park C-W, Mazaki-Tovi S, Hyun Yoon B, Romero R (2011) The frequency of meconium-stained amniotic fluid increases as a function of the duration of labor. The Journal of Maternal-Fetal & Neonatal Medicine 24 (7): 880-885. doi: https://doi.org/10.3109/14767058.2010.531329
  17. Choi W, Jeong H, Choi S-J, Oh S-Y, Kim J-S, Roh C-R, Kim J-H (2015) Risk factors differentiating mild/moderate from severe meconium aspiration syndrome in meconium-stained neonates. Obstetrics & gynecology science 58 (1): 24-31. doi: https://doi.org/10.5468/ogs.2015.58.1.24