The relative risk of 'fetal distress' in pregnancy associated with meconium-stained liquor at different gestation

Abstract

Pregnancies complicated with meconium-stained liquor are regarded as at risk of fetal distress. Evidence from animal and human studies indicate that passage of meconium may be related to fetal maturity. This retrospective study attempts to quantify the relative risk of non-reassuring cardiotocography or 'fetal distress' in pregnant women complicated by meconium-stained liquor for preterm, term and post-term pregnancies. A total of 9542 singleton pregnancies, delivered in a tertiary obstetric unit in Hong Kong between 1 July 1996 and 31 June 1999, were included in the study. Of these pregnancies, 1946 (20.4%) were identified as having meconium-stained liquor, ranging from thin to thick staining. There was a strong association between incidence of meconium-stained liquor (P < 0.0005) and moderate/thick meconium-stained liquor with advanced gestational age. The incidence of non-reassuring cardiotocography in women presenting with meconium-stained liquor was significantly higher (9.8% vs. 6.4%). The relative risk of non-reassuring cardiotocography in women with meconium-stained liquor increased with more advanced gestation. Close fetal surveillance during labour is required among these pregnancies. Premature labour is associated with higher incidence of fetal distress but the presence of meconium did not pose an additional risk.

Perinatal and neonatal outcome in meconium stained amniotic fluid

“…The reason for higher incidence of LSCS in our study among the cases was because of associated abnormal CTG findings especially in patients with thick meconium. Similar results were noted by Gupta et al, Naqvi et al, Khatun et al, Wong SF et al, Mundhra et al 7,9,10,12,13 Apgar score was noted in all the babies at 1 minute and 5 minutes and resuscitation was done in non-vigorous babies with low APGAR score. One baby in each group had APGAR score of 0 at birth and after resuscitation in our study.…”

Comparison of neonatal outcome parameters between thick and thin meconium stained liquor: a prospective study

“…The incidence of thick meconium was significantly higher in patients with post term pregnancy (15.71% vs 2.5% p=0.004), oligohydramnios (12.8% vs 1.2 %, p=0.01) and in unbooked cases (44.2% vs 18.7%, p=0.007. Similar findings were seen in the studies done by Wong et al, Sheiner et al and Yinka Oyelese et al [10][11][12] The increased incidence of meconium staining in oligohydramnios may be the result of intrapartum fetal distress as a consequence of cord compression. It is also likely that meconium released into an already reduced amniotic fluid volume causes thick, viscous meconium staining.…”

Effect of Meconium-Stained Amniotic Fluid on Perinatal Complications in Low-Risk Pregnancies at Term

“…respiratory distress syndrome (RDS), hypoglycemia, and seizures. 1,3,4,[12][13][14][15][16] Nevertheless, most studies that demonstrated increased rate of perinatal complications in women with MSAF addressed a heterogeneous obstetrical population of low-and high-risk pregnancies. While some did not exclude maternal comorbidities, others reported pregnancy outcome in high-risk pregnancies, and moreover included preterm deliveries, 2,3 which are all considered independent risk factors for adverse perinatal outcomes.…”