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羊水胎粪污染分娩时的即时胎儿结局

Immediate Fetal Outcome in Deliveries with Meconium Stained Amniotic Fluid.

作者信息

Ghimire Bijaya, Pathak Pratima, Gachhadar Rashmi, Ghimire Pratima, Baidya Sujita

机构信息

Department of Nursing, Nepal Medical College, Kathmandu University, Jorpati, Kathmandu, Nepal.

Institute of Medicine, Tribhuvan University, Maharajgunj Nursing Campus.

出版信息

J Nepal Health Res Counc. 2022 Mar 13;19(4):681-687. doi: 10.33314/jnhrc.v19i04.3842.

Abstract

BACKGROUND

Meconium-stained amniotic fluid is considered as the bad predictor of fetal outcome having significant perinatal morbidity and mortality. This study aimed to compare immediate fetal outcomes in meconium-stained amniotic fluid and clear amniotic fluid.

METHODS

Hospital-based comparative observational study was conducted from a total of 204 women admitted in labour room at a tertiary level hospital. Among them, 102 were cases with meconium-stained amniotic fluid, and 102 were comparison groups with clear amniotic fluid. Fetal outcome was compared between these two groups.

RESULTS

The study findings revealed that majority (74.5%) in the study group had cesarean section as compared to 14.7% in the comparative group. More than one-fourth (26.5%) of the newborns in the study group had moderate to severe birth asphyxia, needed resuscitation (25.5%) and neonatal intensive care unit admission (25.5%) as compared to 3.9% from the comparative group. Maternal age (COR=0.34, 95%CI=0.15-0.81), color of amniotic fluid (COR=0.11; 95%CI=0.04-0.33), meconium consistency (COR=0.27; 95%CI=0.17-0.43), and mode of delivery (COR=0.36; 95%CI=0.17-0.79) were associated with birth asphyxia in bivariate analysis. Maternal age (AOR=2.66; 95%CI=1.04-6.81) and color of amniotic fluid (AOR=11.50; 95%CI=2.97-44.56) were associated with birth asphyxia in the multivariate analysis.

CONCLUSIONS

Meconium-stained amniotic fluid was associated with increased frequency of cesarean section and adverse fetal outcome with birth asphyxia being the major complications compared with clear amniotic fluid. Predictors of birth asphyxia were maternal age and color of amniotic fluid.

摘要

背景

羊水胎粪污染被认为是胎儿结局的不良预测指标,会导致显著的围产期发病率和死亡率。本研究旨在比较羊水胎粪污染和羊水清澈时的即刻胎儿结局。

方法

在一家三级医院的产房对总共204名入院分娩的妇女进行了基于医院的比较观察性研究。其中,102例为羊水胎粪污染病例,102例为羊水清澈的对照组。比较两组的胎儿结局。

结果

研究结果显示,研究组中大多数(74.5%)进行了剖宫产,而对照组为14.7%。研究组中超过四分之一(26.5%)的新生儿有中度至重度出生窒息,需要复苏(25.5%)和入住新生儿重症监护病房(25.5%),而对照组为3.9%。在双变量分析中,产妇年龄(校正比值比[COR]=0.34,95%置信区间[CI]=0.15 - 0.81)、羊水颜色(COR=0.11;95%CI=0.04 - 0.33)、胎粪黏稠度(COR=0.27;95%CI=0.17 - 0.43)和分娩方式(COR=0.36;95%CI=0.17 - 0.79)与出生窒息有关。在多变量分析中,产妇年龄(调整后比值比[AOR]=2.66;95%CI=1.04 - 6.81)和羊水颜色(AOR=11.50;95%CI=2.97 - 44.56)与出生窒息有关。

结论

与羊水清澈相比,羊水胎粪污染与剖宫产频率增加及不良胎儿结局相关,出生窒息是主要并发症。出生窒息的预测因素是产妇年龄和羊水颜色。

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