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KMID : 0358419920350081120
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Korean Journal of Obstetrics and Gynecology
1992 Volume.35 No. 8 p.1120 ~ p.1128
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Interrelationships among Cardiotocogram Patterns , Cord Arterial Blood PH, and Apgar Score in the Cases of Meconium Stained Pregnancy
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선한규/Sun HK
신종철/김진흥/이종건/김수평/김승조/이헌영/Shin JC/Kim JH/Lee CK/Kim SP/Kim SJ/Lee HY
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Abstract
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During the past decase, there has been significant improvement in the obstetrician`s ability to achieve anternatal surveillance. Nevertheless, hypoxia is still a serious danger to the fetus before and during labor even in non high risk groups. And it is wellknown fact that meconium appeared in amniotic fluid under the circumstaces of chronic and acute fetal hypoxic state. Then, cardiotocography alone is insufficient to differentiate whether fetal hypoxia is present or not. This study was performed by retrospective analysis of cardiotocogram, cord arterial blood gas parameters and neonate outcomes in meconium stained 218 cases among 1,749 deliveries which were admitted in St. Mary`s Hospital from July 1,1989 to June 31,1990
The result obtained was as follows;
1. The overall incidence of meconium staining was 12.5% with no sexual difference.
2. The incidence of severe meconium stained case was 46.3%.
3. The severity of meconium staining also increased as the duration of labor. The more incidence rate of meconium staining was noted in primiparous women than multiparous women.
4. The mean value of fetal umbilical arterial pH was shown gradually lower in following order of gestational weeks, 38 weeks(7.37), 39 weeks(7.33), 40 weeks(7.27), 42 weeks(7.24) and 43 weeks (7.23).
5. The incidence of IUGR was 16% in the meconium stained cases, they have lower pH,PO and high PCO2 than in the cases of adequate for gestational age.
6. The acidosis and preacidosis was more ferquently occurred in the cases of over 41 weeks.
7. The incidence of abnormal F.H.R. pattern was 38.5% among the meconium stained cases and abnormal F.H.R. pattern group has lowere Apgar score.
8. The most common mode of delivery in meconium stained group was vaccum extraction(59.7%) to shorten the 2nd stage of labor.
9. Perinatal morbidity rate was 14.6% the most frequent complication was neonatal jaundice. The meconium aspiration pneumonia were 6 cases.
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