dc.contributor.author | Michoma, Peter M | |
dc.date.accessioned | 2016-05-23T06:09:59Z | |
dc.date.available | 2016-05-23T06:09:59Z | |
dc.date.issued | 2005 | |
dc.identifier.uri | http://hdl.handle.net/11295/95868 | |
dc.description.abstract | Introduction
Although the finding of meconium stained amniotic fluid in labor is clinically significant,
meconium per se is not a strong predictor of intrapartum fetal acidosis. Umbilical cord arterial
blood gas analysis performed immediately at birth is the most objective way of determining
fetal/newborn oxygenation status during labor and shortly before birth and can give a guide on
the level of ongoing neonatal care required.
Objective
To use umbilical cord artery blood gas analysis (ABG) to evaluate the diagnostic accuracy of
intrapartum presence of meconium staining of amniotic fluid to diagnose fetal acidosis/ fetal
distress.
Study site
Kenyatta National Hospital Labour ward
Study Design
Prospective Cohort study.
Materials
Umbilical cord arterial blood drawn immediately at birth from a clamped segment of the cord
into a 2 cc syringe already flushed with one drop of heparin. The blood was transported
immediately for blood gas analysis at the hospital intensive care unit where the analyzer is
located. Bayer Diagnostics model 348 blood gas analyzer was used.
Sample size: One hundred (100) newborn umbilical cord arterial blood samples were analyzed;
50 as exposed to meconium stained amniotic fluid (MSAF) in labor and 50 as unexposed to
meconium stained amniotic fluid in labour.
Duration of study
This was a prospective study that was conducted between June 2008 and November 2008 both
months inclusive.
Results
Findings of newborn acidosis was slightly high among meconium stained amniotic fluid (MSAF)
as compared with those with clear liquor (38 per cent versus 20 per cent) (OR-2.5, 95%
Confidence Interval 1.0-6.0, p=0.05).There was no statistical difference of acidosis between the
two groups.
Meconium stained amniotic fluid is associated with increased caesarean section rates P= 0.0001
A low Apgar score below 6 at one minute was associated with finding of newborn acidosis on
umbilical cord arterial blood acid base gas analysis. (Of the ten who had Apgar less than six,
90% had pH below 7.2).
Severe acidosis with pH below 6.9 and attended Apgar score below 7 was associated with
increased rate of need for resuscitation, admission to newborn unit and perinatal morbidity. | en_US |
dc.language.iso | en | en_US |
dc.publisher | University of Nairobi | en_US |
dc.rights | Attribution-NonCommercial-NoDerivs 3.0 United States | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/3.0/us/ | * |
dc.title | Predictive Value Of Meconium Stained Amniotic Fluid In Diagnosis Of Fetal Acidosis | en_US |
dc.type | Thesis | en_US |
dc.description.department | a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya | |