Irish Child Health Database - Peer Reviewed Papers
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Meconium passed in labor: how reassuring is clear amniotic fluid?
Published in:
Obstet Gynecol, Vol: 102, Page: 89-93
Publication Date:
July 2003
Aims & Objectives:
The aim of this study was to assess the incidence of meconium that can only have been passed intrapartum and to determine its neonatal associations and whether its absence is a useful sign
Abstract:
OBJECTIVE: Clear amniotic fluid is frequently considered a reassuring sign during labor. Our aim was to examine the incidence of meconium that can only have been passed intrapartum and to determine its neonatal associations and whether its absence is a useful sign. METHODS: This was a prospective cohort study of 8394 "low risk" laboring women at term with clear amniotic fluid at early amniotomy. RESULTS: Meconium was passed in 5.2% of labors but was not detected until delivery of the fetal head in 51.5% of these. It was associated with moderate-severe acidosis (odds ratio [OR] 4.40; 95% confidence interval [CI] 3.21, 6.03), low Apgar score at 5 minutes (OR 6.49; 95% CI 2.73, 15.44), and neonatal seizures (OR 4.33; 95% CI 3.17, 5.93). However, the sensitivity for these outcomes of the intrapartum passage of meconium and, particularly, its detection before delivery was very poor. CONCLUSION: Although correlated with adverse neonatal outcomes, most affected infants had clear amniotic fluid throughout labor. The presence of clear amniotic fluid is an unreliable sign of fetal well-being.
Authors:
Study Type:
Study Papers » A randomized controlled trial » Descriptive Studies - Studies with a health technology dimension
Categories:
intrapartum meconium
International Classification:
Evaluation of the impact of intrapartum meconium monitoring on managing pregnant women
Keywords:
- Adult
- Amniotic Fluid/ chemistry
- Cohort Studies
- Confidence Intervals
- Delivery, Obstetric/ methods
- Female
- Fetal Distress/ diagnosis
- Fetal Monitoring
- Gestational Age
- Humans
- Infant, Newborn
- Meconium Aspiration Syndrome/ diagnosis/epidemiology
- Meconium/ metabolism
- Odds Ratio
- Predictive Value of Tests
- Pregnancy
- Pregnancy Outcome
- Prevalence
- Prospective Studies
- Reference Values
- Risk Assessment
Geography:
Republic of Ireland and the United Kingdom (UK and Ireland)