{
    "abstract": "Meconium-stained amniotic fluid (MSAF) often signifies colonization of the amniotic sac by microorganisms. This study investigated additional adverse obstetric outcomes associated with MSAF in deliveries complicated by maternal intrapartum fever (IF).\nThis retrospective study included all singleton pregnancies from 2014 to 2020, with intrapartum maternal fever\u2009\u2265\u200938\u00a0\u00b0C during a trial of labor. In accordance with departmental protocol, all patients received intravenous antibiotic therapy consisting of ampicillin and gentamicin in the absence of allergies to these medications. Subsequent antibiotic therapy was adjusted based on the culture results. Antibiotic treatment was discontinued postpartum after 48\u00a0h without fever. Swab cultures were obtained immediately postpartum from both the maternal and fetal sides of the placenta. Maternal and fetal outcomes, along with positive placental cultures, were compared between participants with MSAF&IF and those with clear amniotic fluid &IF (control group).\nIn comparison to the control group (n\u2009=\u20091089), the MSAF&IF group (n\u2009=\u2009264) exhibited significantly higher rates of cesarean delivery (CD) (p\u2009=\u20090.001), CD due to non-reassuring fetal heart rate (p\u2009=\u20090.001), and cord pH\u2009\u2264\u20097.1 (p\u2009=\u20090.004). Positive swab cultures from the placental maternal and fetal sides were more prevalent among the MSAF&IF group (23.1% vs. 17.6%, p\u2009=\u20090.041 and 29.2% vs. 22.9%, p\u2009=\u20090.032, respectively). Placental cultures yielding gastrointestinal pathogens and extended spectrum beta-lactamase were notably more common in the MSAF&IF group compared to controls (p\u2009=\u20090.023). However, there was no significant difference between groups regarding the rate of group B streptococcus positive placental cultures.\nWomen experiencing IF and MSAF during labor face an elevated risk of CD compared to those with IF alone. The presence of MSAF heightens the risk of positive placental cultures, particularly with gastrointestinal and extended spectrum beta-lactamase pathogens.",
    "authors": [
        {
            "affiliation": "Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tchernichovsky St., 44281, Kfar Saba, Israel. Hanochsc@gmail.com.\nSchool of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel. Hanochsc@gmail.com.",
            "firstname": "Hanoch",
            "initials": "H",
            "lastname": "Schreiber"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tchernichovsky St., 44281, Kfar Saba, Israel.\nSchool of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.",
            "firstname": "Gal",
            "initials": "G",
            "lastname": "Cohen"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tchernichovsky St., 44281, Kfar Saba, Israel.\nSchool of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.",
            "firstname": "Maya",
            "initials": "M",
            "lastname": "Zahavi"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tchernichovsky St., 44281, Kfar Saba, Israel.\nSchool of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.",
            "firstname": "Izaac",
            "initials": "I",
            "lastname": "Wiener"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tchernichovsky St., 44281, Kfar Saba, Israel.\nSchool of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.",
            "firstname": "Tal",
            "initials": "T",
            "lastname": "Biron-Shental"
        },
        {
            "affiliation": "Infectious Diseases Unit, Meir Medical Center, Kfar Saba, Israel.\nSchool of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.",
            "firstname": "Michal",
            "initials": "M",
            "lastname": "Chowers"
        },
        {
            "affiliation": "Department of Obstetrics and Gynecology, Meir Medical Center, 59 Tchernichovsky St., 44281, Kfar Saba, Israel.\nSchool of Medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.",
            "firstname": "Michal",
            "initials": "M",
            "lastname": "Kovo"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.",
    "doi": "10.1007/s00404-024-07673-1\n10.1016/j.ogrm.2018.02.004\n10.1016/j.ajog.2014.06.033\n10.1016/j.ejogrb.2020.02.028\n10.1080/14767058.2019.1671338\n10.1055/s-0035-1565989\n10.1080/14767058.2021.1919077\n10.14734/PN.2020.31.1.7\n10.1016/j.ejogrb.2021.09.016\n10.1007/s00404-011-1969-8\n10.1016/0002-9378(91)90529-z\n10.3109/14767058.2013.844124\n10.3109/14767058.2013.847918\n10.1542/peds.113.6.1776\n10.1016/j.taap.2012.03.010\n10.1016/j.ajog.2020.09.044\n10.1016/j.ajog.2023.02.002\n10.1007/s00404-020-05815-9\n10.1055/s-0028-1085624\n10.1016/j.ajog.2023.05.013\n10.1159/000440938\n10.3109/01443615.2014.925858\n10.3390/jcm13030814\n10.1016/j.ajog.2017.02.022\n10.1016/s0029-7844(01)01361-8\n10.1080/15513810600908461\n10.1016/j.ajog.2022.06.017\n10.1016/j.ajog.2022.11.1283\n10.1016/0029-7844(95)00265-S\n10.1086/420816",
    "journal": "Archives of gynecology and obstetrics",
    "keywords": [
        "Chorioamnionitis",
        "Extended spectrum beta-lactamase pathogens",
        "Intrapartum fever",
        "Meconium-stained amniotic fluid"
    ],
    "methods": null,
    "publication_date": "2024-08-02",
    "pubmed_id": "39093332\n24949543\n32146227\n31570021\n26479168\n33910465\n34592650\n21735187\n1900664\n24028637\n15173506\n22465937\n33007269\n38233317\n33123808\n18756433\n38051599\n26536344\n24937098\n38337508\n28216060\n11430951\n17060193\n37164496\n37012128\n7566858\n15206050",
    "results": "In comparison to the control group (n\u2009=\u20091089), the MSAF&IF group (n\u2009=\u2009264) exhibited significantly higher rates of cesarean delivery (CD) (p\u2009=\u20090.001), CD due to non-reassuring fetal heart rate (p\u2009=\u20090.001), and cord pH\u2009\u2264\u20097.1 (p\u2009=\u20090.004). Positive swab cultures from the placental maternal and fetal sides were more prevalent among the MSAF&IF group (23.1% vs. 17.6%, p\u2009=\u20090.041 and 29.2% vs. 22.9%, p\u2009=\u20090.032, respectively). Placental cultures yielding gastrointestinal pathogens and extended spectrum beta-lactamase were notably more common in the MSAF&IF group compared to controls (p\u2009=\u20090.023). However, there was no significant difference between groups regarding the rate of group B streptococcus positive placental cultures.",
    "title": "Adverse obstetric outcomes in cases of meconium-stained amniotic fluid complicated with intrapartum fever.",
    "xml": "<Element 'PubmedArticle' at 0x78850569dee0>"
}