Meconium-stained Amniotic Fluid Clinical Analysis Of Effects On Perinatal Outcome

Objective: To study the risk factors and the degree of amniotic fluid infection in newborn asphyxia,aspiration pneumonia,hypoxic ischemic encephalopathy incidence and delivery methods.Methods: Take pregnant women whose gestational period over 37 weeks as the research subjects with singleton and head delivery in our hospital from January to December in 2015.And there are totally 1456 patients met the research criteria,of which 327 cases of amniotic fluid were taken as the observation group,1129 cases of amniotic fluid clear patients as the control group.The following indicators were studied: 1 Occurrence rate of amniotic fluid;2 The composition of the high risk factors of amniotic fluid;3Comparison of the incidence of asphyxia,aspiration pneumonia,hypoxic ischemic encephalopathy between the observation group and the control group;4 The effect of different levels of amniotic fluid and feces on neonatal outcomes in the observation group;5The influence of the time limit of amniotic fluid feces staining on the adverse neonatal outcomes;and 6 the relations between the characters of amniotic fluid and the incidence of abnormal heart monitoring7 Effect of amniotic fluid on the way of delivery.Result:1 The incidence for patients between 37 weeks and 41+6 weeks with amniotic fluid stain rate was 21.9%,and for patients over 42 weeks was 57.8%.2 The ingredients of High risk factors of amniotic fluid stain includes the following factors,Umbilical cord related factors(32.1%),Oligohydramnios(22.6%),Premature rupture of membranes(19.0%),Production process anom-aly(16.5%),Fetal growth restriction(6%),and Prolonged pregnancy(3.4%).3 The incidence rate of asphyxia,aspiration pneumonia and hypoxic ischemic encephalopathy in the observation group were14.9%,7.3%and 3.3%,respectively.These numbers are all higher than the control group,which were5.7%,3.1%and 1.5% respectively.The difference was statistically significant(P<0.05).4 For the maternal amniotic fluid stained with I degree,II degree and III degree,the incidence rates of neonatal asphyxia were 6.9%,14.0%,and 29.4% respectively,the incidence of aspiration pneumonia rates were 3.4%,8.0%,and 12.9% respectively,and the incidence of neonatal hypoxic ischemic encephalopathy rates were 0.6%,4.0%,and 7.0% respectively.In the three groups,the incidence rate of adverse outcomes was significantly higher in the third degree of amniotic fluid,and the difference was statistically significant(P<0.05).5 The incidences of neonatal asphyxia in the latent period and active period were 17.3% and 11.4% respectively,and the incidences of aspiration pneumonia were 8.6% and 5.3% respectively,and the incidences of ischemic hypoxic encephalopathy were 4.1% and 2.3% respectively.Both of the difference was statistically significant(P<0.05).6 To study the abnormal graphs of fetal heart monitoring in cases of parturients with normal amniotic fluid,the incidence is 19.3%,while 29.6% of parturients with degree Ⅰ of meconium contamination,46%ofparturients with degree II ofmeconium contamination,and 64.7% of parturients with degreof e III meconium contamination.The difference was statistically significant in the incidence of abnormal heart monitoring in any two groups above(X2=116.609,P<0.001).7 Sparing the other factors,compare to the control group in the cesarean section rate was 31.4%,vaginal delivery rate was 2.3%,in the observation group,meconium staining I,II,III degrees of cesarean section were respectively 33.8%,38.0%,60.0%,and the vaginal delivery(Including the fetal head suction and forceps)rate were 3.5%,6%,14.1%.In this study,we found that meconium staining in patients with cesarean section rate and vaginal delivery rate compared to the amniotic fluid clear increase with meconium staining increased,and the difference was statistically significant(P<0.05)).Conclusion:Amniotic fluid feces infected patients with neonatal asphyxia,aspiration pneumonia and hypoxic ischemic encephalopathy and other adverse outcomes higher ratio,and Amniotic fluid feces stained the earlier,the more severe,there will be the higher proportion of adverse neonatal outcomes.