morphine and Placenta--Retained

To evaluate the impact of prolonged exposure to meconium-stained amniotic fluid (MSAF), in women with term pre-labor spontaneous rupture of membranes (PROM), on pregnancy outcome.. A retrospective cohort study of women who gave birth in a single university-affiliated tertiary medical center (2011-2019). Eligibility was limited to singleton pregnancies at term who presented with PROM. Women with MSAF were immediately induced and were compared to low-risk pregnant women with clear amniotic fluid (CAF) at admission who underwent induction of labor 24 h after rupture of membranes. All women were stratified into 4-time frame groups from rupture of membranes to delivery: T0: 0-7 h, T1: 8-13 h, T2: 14-18 h, and T3: > 18 h for the MSAF group. The time frames for the CAF were: T0 - 24-31 h, T1: 32-38 h, T2: 40-44 h, and T3: > 44 h. The maternal adverse composite outcome included any of the following: intrapartum fever (IPF), prolonged second stage (PSS), need for manual removal of suspected retained placenta, postpartum hemorrhage, and readmission within 45 days after delivery. The adverse composite neonatal outcome included one or more of the following: meconium aspiration syndrome, neonatal asphyxia, need for respiratory support, and intracranial hemorrhage.. Prolonged rupture of membranes in the presence of meconium does not affect maternal outcomes, however, prolonged exposure to meconium lead to an increased adverse neonatal outcome.

Topics: Amniotic Fluid; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Meconium Aspiration Syndrome; Placenta, Retained; Postpartum Hemorrhage; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Premature Birth; Retrospective Studies; Rupture, Spontaneous