Perinatal outcome in relation to mode of delivery in meconium stained amniotic fluid

Abstract

Meconium staining of the amniotic fluid is a common complication during labour. When facilities like electronic monitoring, foetal blood sampling are not available, it is difficult to decide whether labour should be allowed to continue or caesarean section should be done. Even when caesarean section is done, meconium aspiration syndrome (MAS) can still occur and considerable morbidity and mortality may result in the newborn. Amino infusion is being considered as useful in decreasing MAS and its sequelae. Before resorting to amino infusion, we decided to analyse the perinatal outcome in meconium stained liquor to compare whether early caesarean section offered any advantage. This is a retrospective study of 150 labours complicated by thick meconium stained liquor, during a 12 month period (1992-93).

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

“…This is because thick meconium tends to occur later in second stage, perhaps during the instrumental delivery. Finding of this study is comparable to the 6 Clifford et al found cesarean section rate of 38% in MSAF group as compared to 26% in clear liquor group. 13 In the present study the association of MSAF with low Apgar was strong, 22.8% of thick MSAF babies had low Apgar score (<5) at one minute as compared with thin MSAF born babies.…”

“…Intrauterine asphyxia also produces a gasping response by which meconium enters the trachea and once it has been aspirated into lungs it causes mechanical obstruction to airways, chemical pneumonitis and atelactasis. 6 Approximately 10-20% of live births demonstrate meconium in the amniotic fluid, yet few infants are adversely affected. Therefore the current risks associated with meconium remains uncertain and Gupta SN et al September-December 2012;Vol 10 (No.3);198-202 Maternal & fetal outcome in term labour controversial.…”

Fetal outcome in deliveries with meconium stained liquor

“…In present study, 75% cases had normal fetal heart rate at the time of detection of meconium, 18% had bradycardia & 7% had tachycardias which were similar with the findings of Berkus et al 8 who observed significantly higher risk of an abnormal fetal heart rate in meconium stained group. Sasikala et al 9 found that 26.2% had fetal bradycardia & 6.5% had tachycardia. In present study, APGAR score in first minute was low (<7) in 5.26% patients with thin meconium as compared to 18.51% of patients with thick meconium.…”

Study of Nucleated RBCS in Cord Blood of Neonates With Meconium Stained Amniotic Fluid.

“…Amniotic Fluid surrounds the fetus in intrauterine life providing low resistance space suitable for growth and development. (1) .…”