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羊水 胎糞着色의 臨床的 觀察

Clinical Study on the Cases of Meconium Stained Amniotic Fluid

대한산부인과학회지 1970년 13권 3호 p.19 ~ 24
김두호 (  ) - 고려병원 산부인과

Abstract


This study was carried out retrospectively based on the clinical observation of the 83 cases of meconium staining amniotic fluid in 1, 148 deliveries at the Department of Obstetrics and Gynecology, In-Chun Christian Hospital, from May, 1967 to May, 1968.
The results were as follows:
1. The incidence was 7.2%, the meconium stained amniotic fluid was occured primigravida in 74.6%, multigravida in 25.4%.
It occurs 3 times more in primigravida than in multigravida. 2. It occurs mostly at 40th weeks or more in pregnant period.
3. Fetal maturity: Mature group was in 73. 1%, Premature group was in 26.7%. Mature group was about 3 times more than premature group.
4. Fetal distress was occured in 9.4% of which was meconium staining amniotic fluid as well as irregularity of fetal heart tone or if tone below 100 per minute or more than 160 per minute. Still birth rate was in 38%, it was about from 6 to 8 times higher than normal rate. Etiology
of fetall distress was investigated not only fetal anoxia but also vagal nerve tension.
5. Premature rupture of membranes : occured 67 cases. in 415 cases. It was revealed as high in 80.7%.
6. In the over term group, control group was in 30%, spontaneous delivery group was in 40.2% and pitocin induction group was in 43.4%.
It was presumptive largely based on fetoplacental dysfunction.
7. Intrauterine bacterial infection was not significant to prophylactic antibiotics- but S. P.R.M., prolonged labor, and general conditions of mother were major cause and also sterilized vaginal examination was important. All of these. were great influence. to fetal morbidity, mortality and maternal mortality.
8. In the prolonged labor meconium stained amniotic fluid was occured higher than 25% in over the 30 hours of total -length of labor, especially it was occured 28.4% in primigravida. 9. Maternal morbidity. was 4.2%.
10. Permatal morbidity was difficult to calculate because patient could not be followed up after discharge. Fatal death was 5 cases.
11. Meconium stained placental weight was average in 544.7gm. Pathologic tissue study was not performed in all cases but amnionitis was found in 8 cases.

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