Intrapartum care algorithms for liquor abnormalities: oligohydramnios, meconium, blood and purulent discharge

T Liabsuetrakul; S Meher

doi:10.1111/1471-0528.16728

Intrapartum care algorithms for liquor abnormalities: oligohydramnios, meconium, blood and purulent discharge

T Liabsuetrakul
, S Meher
,

Research output: Contribution to journal › Review article › peer-review

Abstract

AIM: To construct evidence-based algorithms for the assessment and management of common amniotic fluid abnormalities detected during labour.

POPULATION: Low-risk singleton, term pregnant women in labour.

SETTING: Birth facilities in low- and middle-income countries.

SEARCH STRATEGY: We searched international guidelines published by the American College of Obstetricians and Gynecologists (ACOG), the National Institute for Health and Care Excellence (NICE), the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), the Royal College of Obstetricians and Gynaecologists (RCOG), the Society of Obstetrics and Gynaecology (SOGC) and the World Health Organization (WHO). We also searched The Cochrane Library and MEDLINE up to 20 January 2020 using keywords for relevant systematic reviews and randomised trials.

CASE SCENARIOS: We developed evidence-based intrapartum care algorithms for four case scenarios: oligohydramnios; meconium-stained amniotic fluid; bloody amniotic fluid or vaginal bleeding; and purulent amniotic fluid or discharge. These conditions may be associated with fetal and /or maternal morbidity. Differential diagnosis includes uteroplacental insufficiency, fetal growth restriction, fetal distress, abruption, placenta or vasa praevia, uterine rupture and intra-amniotic infection, respectively. Algorithms include how to assess for, diagnose and manage these conditions.

CONCLUSIONS: Four algorithms are presented, to provide a systematic approach and guidance on the clinical management for the following amniotic fluid abnormalities: oligohydramnios; meconium-stained liquor; bloody amniotic fluid or vaginal bleeding; and purulent amniotic fluid or discharge. These algorithms may be beneficial in supporting clinical decision making, particularly in low-resource settings.

TWEETABLE ABSTRACT: Evidence based algorithms for management of common amniotic fluid abnormalities seen during labour.

Original language	English
Pages (from-to)	90-101
Number of pages	12
Journal	BJOG - An International Journal of Obstetrics and Gynaecology
Volume	131
Issue number	S2
Early online date	12 Apr 2022
DOIs	https://doi.org/10.1111/1471-0528.16728
Publication status	Published - Aug 2024
Externally published	Yes

Keywords

Amniotic fluid
bleeding
chorioamnionitis
intrapartum
liquor
meconium
oligohydramnios

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10.1111/1471-0528.16728

Cite this

@article{73da568954254fcabcdf8dba61b7de68,

title = "Intrapartum care algorithms for liquor abnormalities: oligohydramnios, meconium, blood and purulent discharge",

abstract = "AIM: To construct evidence-based algorithms for the assessment and management of common amniotic fluid abnormalities detected during labour.POPULATION: Low-risk singleton, term pregnant women in labour.SETTING: Birth facilities in low- and middle-income countries.SEARCH STRATEGY: We searched international guidelines published by the American College of Obstetricians and Gynecologists (ACOG), the National Institute for Health and Care Excellence (NICE), the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), the Royal College of Obstetricians and Gynaecologists (RCOG), the Society of Obstetrics and Gynaecology (SOGC) and the World Health Organization (WHO). We also searched The Cochrane Library and MEDLINE up to 20 January 2020 using keywords for relevant systematic reviews and randomised trials.CASE SCENARIOS: We developed evidence-based intrapartum care algorithms for four case scenarios: oligohydramnios; meconium-stained amniotic fluid; bloody amniotic fluid or vaginal bleeding; and purulent amniotic fluid or discharge. These conditions may be associated with fetal and /or maternal morbidity. Differential diagnosis includes uteroplacental insufficiency, fetal growth restriction, fetal distress, abruption, placenta or vasa praevia, uterine rupture and intra-amniotic infection, respectively. Algorithms include how to assess for, diagnose and manage these conditions.CONCLUSIONS: Four algorithms are presented, to provide a systematic approach and guidance on the clinical management for the following amniotic fluid abnormalities: oligohydramnios; meconium-stained liquor; bloody amniotic fluid or vaginal bleeding; and purulent amniotic fluid or discharge. These algorithms may be beneficial in supporting clinical decision making, particularly in low-resource settings.TWEETABLE ABSTRACT: Evidence based algorithms for management of common amniotic fluid abnormalities seen during labour.",

keywords = "Amniotic fluid, bleeding, chorioamnionitis, intrapartum, liquor, meconium, oligohydramnios",

author = "T Liabsuetrakul and S Meher",

note = "Funding Information: This work was funded by the Bill \& Melinda Gates Foundation (grant no. OPP1084318), the United States Agency for International Development (USAID) and the UNDP‐UNFPA‐UNICEF‐WHO‐World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), a co‐sponsored programme executed by the World Health Organization (WHO). The funders had no role in the design, data collection and analysis, decision to publish or preparation of the article. Publisher Copyright: {\textcopyright} 2022 John Wiley \& Sons Ltd.",

year = "2024",

month = aug,

doi = "10.1111/1471-0528.16728",

language = "English",

volume = "131",

pages = "90--101",

journal = "BJOG - An International Journal of Obstetrics and Gynaecology",

issn = "1470-0328",

publisher = "John Wiley \& Sons Inc.",

number = "S2",

}

TY - JOUR

T1 - Intrapartum care algorithms for liquor abnormalities

T2 - oligohydramnios, meconium, blood and purulent discharge

AU - Liabsuetrakul, T

AU - Meher, S

N1 - Funding Information: This work was funded by the Bill & Melinda Gates Foundation (grant no. OPP1084318), the United States Agency for International Development (USAID) and the UNDP‐UNFPA‐UNICEF‐WHO‐World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), a co‐sponsored programme executed by the World Health Organization (WHO). The funders had no role in the design, data collection and analysis, decision to publish or preparation of the article. Publisher Copyright: © 2022 John Wiley & Sons Ltd.

PY - 2024/8

Y1 - 2024/8

N2 - AIM: To construct evidence-based algorithms for the assessment and management of common amniotic fluid abnormalities detected during labour.POPULATION: Low-risk singleton, term pregnant women in labour.SETTING: Birth facilities in low- and middle-income countries.SEARCH STRATEGY: We searched international guidelines published by the American College of Obstetricians and Gynecologists (ACOG), the National Institute for Health and Care Excellence (NICE), the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), the Royal College of Obstetricians and Gynaecologists (RCOG), the Society of Obstetrics and Gynaecology (SOGC) and the World Health Organization (WHO). We also searched The Cochrane Library and MEDLINE up to 20 January 2020 using keywords for relevant systematic reviews and randomised trials.CASE SCENARIOS: We developed evidence-based intrapartum care algorithms for four case scenarios: oligohydramnios; meconium-stained amniotic fluid; bloody amniotic fluid or vaginal bleeding; and purulent amniotic fluid or discharge. These conditions may be associated with fetal and /or maternal morbidity. Differential diagnosis includes uteroplacental insufficiency, fetal growth restriction, fetal distress, abruption, placenta or vasa praevia, uterine rupture and intra-amniotic infection, respectively. Algorithms include how to assess for, diagnose and manage these conditions.CONCLUSIONS: Four algorithms are presented, to provide a systematic approach and guidance on the clinical management for the following amniotic fluid abnormalities: oligohydramnios; meconium-stained liquor; bloody amniotic fluid or vaginal bleeding; and purulent amniotic fluid or discharge. These algorithms may be beneficial in supporting clinical decision making, particularly in low-resource settings.TWEETABLE ABSTRACT: Evidence based algorithms for management of common amniotic fluid abnormalities seen during labour.

AB - AIM: To construct evidence-based algorithms for the assessment and management of common amniotic fluid abnormalities detected during labour.POPULATION: Low-risk singleton, term pregnant women in labour.SETTING: Birth facilities in low- and middle-income countries.SEARCH STRATEGY: We searched international guidelines published by the American College of Obstetricians and Gynecologists (ACOG), the National Institute for Health and Care Excellence (NICE), the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG), the Royal College of Obstetricians and Gynaecologists (RCOG), the Society of Obstetrics and Gynaecology (SOGC) and the World Health Organization (WHO). We also searched The Cochrane Library and MEDLINE up to 20 January 2020 using keywords for relevant systematic reviews and randomised trials.CASE SCENARIOS: We developed evidence-based intrapartum care algorithms for four case scenarios: oligohydramnios; meconium-stained amniotic fluid; bloody amniotic fluid or vaginal bleeding; and purulent amniotic fluid or discharge. These conditions may be associated with fetal and /or maternal morbidity. Differential diagnosis includes uteroplacental insufficiency, fetal growth restriction, fetal distress, abruption, placenta or vasa praevia, uterine rupture and intra-amniotic infection, respectively. Algorithms include how to assess for, diagnose and manage these conditions.CONCLUSIONS: Four algorithms are presented, to provide a systematic approach and guidance on the clinical management for the following amniotic fluid abnormalities: oligohydramnios; meconium-stained liquor; bloody amniotic fluid or vaginal bleeding; and purulent amniotic fluid or discharge. These algorithms may be beneficial in supporting clinical decision making, particularly in low-resource settings.TWEETABLE ABSTRACT: Evidence based algorithms for management of common amniotic fluid abnormalities seen during labour.

KW - Amniotic fluid

KW - bleeding

KW - chorioamnionitis

KW - intrapartum

KW - liquor

KW - meconium

KW - oligohydramnios

UR - https://www.scopus.com/pages/publications/85133503636

U2 - 10.1111/1471-0528.16728

DO - 10.1111/1471-0528.16728

M3 - Review article

C2 - 35415944

SN - 1470-0328

VL - 131

SP - 90

EP - 101

JO - BJOG - An International Journal of Obstetrics and Gynaecology

JF - BJOG - An International Journal of Obstetrics and Gynaecology

IS - S2

ER -

Intrapartum care algorithms for liquor abnormalities: oligohydramnios, meconium, blood and purulent discharge

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Keywords

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