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New Evidence to Support Antibiotic Prophylaxis in Meconium-Stained Amniotic Fluid in Low-Risk Women in Labor a Prospective Cohort Study

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Abstract

Purpose of study

To assess the maternal and perinatal complications associated with meconium-stained amniotic fluid (MSAF) in low-risk women in labor.

Methods

This prospective cohort study was conducted at CMC Hospital, Vellore, India. Two hundred low-risk women who had artificial or spontaneous rupture of membranes after admission with MSAF were included in the study. Two hundred similar women with clear liquor were taken as controls. The primary outcomes considered were the incidence of chorioamnionitis and endomyometritis in the mothers. The secondary outcomes included postpartum hemorrhage and retained placenta in the mothers and respiratory distress, meconium aspiration, sepsis, and NICU admission in the newborn. Statistical analysis was done using Fischer exact test. Odds ratio, 95% confidence interval, and P value were estimated.

Results

Compared to controls, those with MSAF had significantly higher rates of chorioamnionitis (2 vs. 8%, P = 0.006) and endomyometritis (3 vs. 9.5% P = 0.007). Among the secondary end points, only neonatal respiratory distress (8.5 vs. 1.5%; P = 0.001) and meconium aspiration (4 vs. 0%; P = 0.007) were found to be significantly increased in the meconium group.

Conclusion

Statistically significant increased incidence of chorioamnionitis and endomyometritis in women with MSAF in labor established in our study strongly supports the use of prophylactic antibiotics in these women to prevent immediate and long-term consequences.

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Acknowledgements

Ms. Grace Rebecca for statistical analysis.

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Authors and Affiliations

  1. Unit 1, Department of Obstetrics and Gynecology, Christian Medical College and Hospital, Vellore, 632004, India

    Kavitha Abraham, Elsy Thomas & Jessie Lionel

Authors
  1. Kavitha Abraham
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  2. Elsy Thomas
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  3. Jessie Lionel
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Corresponding author

Correspondence to Kavitha Abraham.

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Conflict of interest

All authors declare that they have no conflict of interest.

Ethical Standards

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the 1975 Declaration of Helsinki, as revised in 2008 (5).

Informed Consent

Informed consent was obtained from all patients for being included in the study.

Additional information

Kavitha Abraham is an Assistant Professor, Elsy Thomas is a Professor, Jessie Lionel is a Professor and HOD at Department of Obstetrics and Gynecology, Christian Medical College and Hospital, Vellore, India.

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Abraham, K., Thomas, E. & Lionel, J. New Evidence to Support Antibiotic Prophylaxis in Meconium-Stained Amniotic Fluid in Low-Risk Women in Labor a Prospective Cohort Study. J Obstet Gynecol India 68, 360–365 (2018). https://doi.org/10.1007/s13224-017-1043-y

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  • DOI: https://doi.org/10.1007/s13224-017-1043-y

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