Obstetric and perinatal outcome of pregnancies with term labour and meconium-stained amniotic fluid

Abstract

The purpose of this study was to evaluate the meconium staining of amniotic fluid (AF) in term of fetal distress, meconium aspiration syndrome, and perinatal morbidity and mortality. In a prospective study at Princess Badeea Teaching Hospital from April to November 1999, women with a singleton cephalic pregnancy of completed 37-42 weeks and with no pre-defined risk factor were recruited into the study. Study patients comprised 390 (10%) patients with meconium and 400 patients as controls but with clear amniotic fluid. Virtually meconium staining of the amniotic fluid was significantly associated with poor neonatal outcome in all outcomes measures assessed. Perinatal mortality increased from 2 per 1000 births with clear AF to 10 per 1000 with meconium (P<0.001). Other adverse outcomes also increased; e. g., severe fetal acidemia, Apgar score < or = 3 at 1 min and 5 min, and meconium aspiration syndrome. Delivery by cesarean section also increased with meconium from 7-14% (P<0.001). We concluded that meconium in the amniotic fluids associated with an obstetric hazard and significantly increase risks of adverse neonatal outcomes. Women with thin meconium in the presence of normal fetal heart rate can be safely managed at the clinical level. Mod-thick meconium alone should alert the obstetrician to a high risk fetal condition. Continuous fetal heart rate monitoring during labour and reassurance of fetal well-being by acid-base assessment were most significant factors in the reduction of meconium aspiration syndrome.

Maternal and fetal outcome in term labour with meconium stained amniotic fluid

“…8,9 In the studies done in India, the range of incidence varied from 7.4% to 14.3%. [10][11][12] In the present study, the incidence was 27% which is higher than reported in most of the literature.…”

“…Ziadeh and Scott both reported increased admission of babies with MSAF to special care unit. 11,14 Among the referred babies 18% were diagnosed as having transient tachypnoeic attack and 20% had hypoxic ischemic encephalopathy as compared to 2% and 6% in respectively in clear liquor. Similarly 4% of the babies developed MAS and 8% had septicemia in MSAF in compared to none and 2% respectively in the clear liquor group.…”

A Prospective Study of Meconium Aspiration Syndrome in Newborns in a District Hospital in Southern India

“…MSAF is associated with fetal acidosis, abnormalities in FHRs and low Apgar scores, suggesting hypoxia as the stimulant of passage of meconium in utero. (16) In accordance with the previous studies post maturity, thick meconium and low Apgar scores were the risk factors of MAS in the present study.…”

Routine interventions in childbirth before and after initiation of an Action Research project

“…Further, if the amniotic fluid is meconium stained the local guidelines advised continuous CTG with a scalp electrode. However, the evidence suggests that thin, old meconium staining does not carry any risks for the neonate [20], so the reduced use of scalp electrodes even though there was a trend for increased meconium stained liquor from 14% to 19% (p=0.050) may suggest that the midwives had increased confidence in physiological labour and birth as the Normal Labour Process and AR projects progressed.…”