Perinatal Outcome Associated with Meconium Stained Amniotic Fluid In Pregnancy

Objectives: To evaluate perinatal outcome associated with meconium stained amniotic fluid in pregnant women.Methods: It was a prospective cross sectional study, conducted in the Department of Obstetrics and Gynecology in Bangabandhu Sheikh Mujib Medical University, Dhaka, from January 2013 to December 2013. Total 50 pregnant women admitted in the labour ward for delivery with meconium stained amniotic fluid were the study population. Singleton pregnancy of more than 34 weeks duration was included and pregnancy with APH, breech presentation, congenital malformation of fetus, IUD were excluded from the study. Out of 50 patients two did not provide all the information needed to analyze the data and hence were excluded. Outcome Variables were gestational age, antenatal checkup, medical diseases of mother (HTN, Diabetes mellitus, Heart disease), obstetric complication (oligohydramnios, prolonged labour), mode of delivery, neonatal details (weight of the baby in kg, APGAR scoring at 1 min & 5 min), neonatal resuscitation, admission in neonatal ICU(NICU), neonatal complications (RDS, MAS, Neonatal death).Results: Over half (52.1%) of the neonates needed resuscitation and 54.2% admitted in ICU. About 90% of the neonates had normal birth weight and only 10.4% were of low birth weight. 14.6% of the neonates developed meconium aspiration syndrome and 10.4% respiratory distress syndrome. Neonatal jaundice and neonatal sepsis were observed in 4.2% neonates each. Four neonates (8.3%) died early in the neonatal life, while 1 (2.1 %) was still-born. Low APGAR score (<7) at 1 and 5 minutes of birth was found in 64.7% and 52.9% of the cases respectively with thick meconium stained amniotic fluid as opposed to 25.8% and 16.1% of the cases respectively having thin meconium stained amniotic fluid (p = 0.008 and p = 0.007 respectively). Thick meconium was significantly associated with meconium aspiration syndrome (p = 0.003). Neonates needing immediate resuscitation and admission in ICU was staggeringly higher in the former group than those in the later group (p = 0.002). The incidence of perinatal death was significantly higher in patients with thick meconium stained amniotic fluid than that in patients with thin meconium ( p= 0.021).Conclusion: Meconium stained amniotic fluid was associated with low APGAR score, higher incidence of MAS, ICU admission and perinatal death.J. Paediatr. Surg. Bangladesh 4(2): 44-49, 2013 (July)

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A study of maternal risk factors and the perinatal outcome in meconium stained amniotic fluid in central referral hospital

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20194837 ◽

2019 ◽

Vol 8 (11) ◽

pp. 4146

Author(s):

Kapil Singh Niranjan ◽

Pesona Grace Lucksom

Keyword(s):

Risk Factors ◽

Amniotic Fluid ◽

Perinatal Outcome ◽

Significant Risk ◽

Birth Asphyxia ◽

Meconium Aspiration Syndrome ◽

Meconium Aspiration ◽

Maternal Risk ◽

Prolonged Labor ◽

Meconium Stained Amniotic Fluid

Background: Meconium staining of amniotic fluid (MSAF) is a significant risk factor for the subsequent development of meconium aspiration syndrome (MAS), respiratory distress and eventual respiratory failure in neonates. To learn more about the risk factors and outcomes associated with MSAF, a prospective case control study was conducted. The objective of the study was to study various maternal risk factors associated with MSAF and to study the outcome of neonates born through MASF and to compare the perinatal outcome in patients with thick and thin meconium stained amniotic fluid.Methods: A hospital based prospective case control study was conducted comparing pregnant women with meconium stained (cases) amniotic fluid with pregnant women having clear liquor (control), 200 in each arm. Singleton pregnancies complicated with MASF were included in the cases group on the basis of predefined inclusion criteria. Various risk factors, mode of delivery, outcome of neonates and perinatal outcome in babies born through thick and thin meconium stained amniotic fluid was studied.Results: Out of 200 patients who had MSAF 114 patients (57%) had thick meconium stained liquor while remaining 86 patients (43.00%) had thin meconium stained amniotic fluid. Post-maturity, pregnancy induced hypertension; oligohydramnios and prolonged labor were found to be statistically significant risk factors for MSAF. Nonreactive non-stress test and Need for cesarean section was more common in women with MSAF as compared to women with clear liquor (p <0.05). Common morbidities in neonates were Birth asphyxia (15%) followed by meconium aspiration syndrome (10%) and hypoxic ischemic encephalopathy (15%).Conclusions: Meconium stained amniotic fluid is more commonly associated with post-maturity, pregnancy induced hypertension, oligohydramnios and prolonged labor low APGAR score and higher incidence of birth asphyxia and NICU admissions. Appropriate management of neonates with meconium aspiration syndrome is crucial to prevent neonatal mortality.

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Study of risk factors and perinatal outcome in meconium stained deliveries from a district of Uttar Pradesh, India

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20183761 ◽

2018 ◽

Vol 7 (9) ◽

pp. 3605

Author(s):

Richa Rathoria ◽

Ekansh Rathoria ◽

Utkarsh Bansal ◽

Madhulika Mishra ◽

Ila Jalote ◽

...

Keyword(s):

Risk Factors ◽

Amniotic Fluid ◽

Perinatal Outcome ◽

Birth Asphyxia ◽

Meconium Aspiration Syndrome ◽

Pregnancy Induced Hypertension ◽

Meconium Aspiration ◽

Fetal Bradycardia ◽

Induced Hypertension ◽

Meconium Stained Amniotic Fluid

Background: The objective is to identify the risk factors of Meconium stained deliveries and evaluate the perinatal outcomes in Meconium Stained deliveries.Methods: This prospective observational study included those pregnant women who had completed 37 weeks of gestation, with singleton pregnancies with cephalic presentations and with no known fetal congenital anomalies. Among these, we selected 110 cases with Meconium stained amniotic fluid and they were compared with 110 randomly selected controls.Results: Regular antenatal visits were seen in 22.73 % of the cases while 77.27% cases had no previous visit. Majority of cases were primigravida and gestational ages of >40 weeks was seen in 55.45 % cases. 19.09% cases had meconium staining among pregnancies complicated with pregnancy induced hypertension, as compared to those among controls (5.45%). Fetal heart rate abnormalities were seen in 29.09% cases, and statistically significant fetal bradycardia was seen in cases. Caesarean section rates were nearly double in cases (54.55%). Poor perinatal outcome was found in cases as seen in results by low Apgar score (<7) at 1 minute and 5-minute, higher incidence of birth asphyxia, Meconium Aspiration Syndrome and increased NICU admission as compared to that among controls.Conclusions: Meconium stained amniotic fluid is more commonly associated with higher gestational age >40 weeks, pregnancy induced hypertension and fetal bradycardia, increased cesarean section rates, low APGAR score and higher incidence of birth asphyxia and NICU admissions. Meconium aspiration syndrome was associated with early neonatal death.

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Meconium Stained Amniotic Fluid – A Potential Predictor Of Meconium Aspiration Syndrome

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v28i1.1397 ◽

1970 ◽

Vol 28 (1) ◽

pp. 3-6 ◽

Cited By ~ 2

Author(s):

P Swain ◽

A Thapalial

Keyword(s):

Amniotic Fluid ◽

Apgar Score ◽

Multiple Logistic Regression Analysis ◽

Univariate Analysis ◽

Significant Risk ◽

Neonatal Morbidity ◽

Meconium Aspiration Syndrome ◽

Meconium Aspiration ◽

Prolonged Labour ◽

Meconium Stained Amniotic Fluid

Objective: To identify potential predictors of Meconium Aspiration Syndrome (MAS) in pregnancies complicated by meconium-stained amniotic fluid (MSAF) & to review the incidence, morbidity and mortality of Meconium Aspiration Syndrome (MAS). Methods: In the period of 2003 to 2006,175 pregnancies with thick meconium-stained AF were delivered; of these, 15 neonates developed MAS and 160 did not. The two groups were compared retrospectively according to maternal findings, pregnancy outcome, and neonatal complications, using univariate analysis (P < 0.05 considered significant) and stepwise multiple logistic regression analysis to identify independent significant factors for prediction of MAS. Results: Incidence of MSAF was 13.97% and that of MAS was 8.57%. All deliveries associated with thick MSAF had developed MAS. 40% mothers were associated with PROM & prolonged labour. Most common & significant risk factors associated with MAS were increased gestational age, increased cesarean section (LSCS) & low Apgar scores at 1 minute and 5 minute. Mortality rate was 6.66% & mechanical ventilation was used in only 1(6.66%) case. Conclusion: MAS are associated with higher incidence of LSCS, lower 1 minute & 5 minute Apgar score & higher gestational weeks. 40% mothers were associated with PROM & prolonged labour. The neonatal morbidity & mortality is significantly more frequent in relation to thick meconium stained amniotic fluid. Specific delivery room resuscitation procedure, early diagnosis & proper management can prevent development of MAS as well as morbidity & mortality. Key words: Meconium Stained Amniotic Fluid, Meconium Aspiration Syndrome and Apgar Score. DOI = 10.3126/jnps.v28i1.1397 J. Nepal Paediatr. Soc. Vol.28(1) p.3-6

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Profil Sindrom Aspirasi Mekonium pada Bayi Baru Lahir di RSUD Dr. Soetrasno Rembang

Smart Medical Journal ◽

10.13057/smj.v1i2.28692 ◽

2019 ◽

Vol 1 (2) ◽

pp. 42

Author(s):

Ahimsa Yoga Anindita ◽

Dwi Hidayah ◽

Yulidar Hafidh ◽

Annang Giri Moelyo ◽

Mayasari Dewi

Keyword(s):

Birth Weight ◽

Amniotic Fluid ◽

Gestational Age ◽

Apgar Score ◽

Meconium Aspiration Syndrome ◽

Normal Birth Weight ◽

Term Infants ◽

Meconium Aspiration ◽

Normal Birth ◽

Minute Apgar Score

Introduction: The presence of meconium in amniotic fluid occurs in 13% of live births in developing countries. This condition develops when the gestational age increases at delivery. Meconium aspiration syndrome occurs in 5% of newborns in meconium stained amniotic fluid. The aim of this study is to determine the profile of newborns who experience meconium aspiration syndrome (MAS) who are treated at Dr. Soetrasno Hospital, Rembang and its outcome.Methods: Prospective study, data were obtained from medical records of Dr. Soetrasno Hospital, Rembang during September to October 2018, on newborns with MAS.Results: Of 12 newborns with MAS were obtained, consisting of 7 (58.3%) male and 5 (41.7%) female. All cases were term infants (gestational age above 37 weeks) and normal birth weight (above 2500 grams). Based on the first minute APGAR score, there were 4 newborns had score 1 and 2, respectively (33.3%). Based on the fifth minute APGAR score, there were 7 newborns had score 3 (58.3%). The outcome of newborns with MAS were 7 alive (58.3%) and 5 died (41.7%).Conclusion: There were 12 newborns suffering from MAS (54.5%) of 22 babies hospitalized at the NICU dr. Soetrasno Hospital Rembang. All newborns with MAS were term infants and normal birth weight. There were 5 newborns with MAS which required invasive mechanical ventilation (intubation) and all died (41.7%).

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Neonatal outcome in meconium stained amniotic fluid: a hospital based study

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20170425 ◽

2017 ◽

Vol 4 (2) ◽

pp. 356 ◽

Cited By ~ 1

Author(s):

Gurmeet Singh ◽

Onkar Singh ◽

Karuna Thapar

Keyword(s):

Respiratory Distress ◽

Amniotic Fluid ◽

Apgar Score ◽

Perinatal Outcome ◽

Neonatal Outcome ◽

Mode Of Delivery ◽

Age At Onset ◽

In Utero ◽

Severe Thrombocytopenia ◽

Meconium Stained Amniotic Fluid

Background: Amniotic fluid surrounds the baby in utero and provides a protective and low resistance environment and acts as a cushion for the baby. It is secreted by amniotic membranes, foetal skin and fetal urine. The objectives of this study was to identify the incidence of meconium stained amniotic fluid, perinatal outcome and the risks during pregnancy leading to in utero passage of meconium.Methods: A prospective study conducted in Sri Guru Ram Das University, Amritsar, between 1st December 2014 to 1st June 2016. All live births with meconim stained amniotic fluid without congenital malformation, twin or multiple organ dysfunction were taken as subjects of this study. Maternal obstetric history and risk factors were asked and foetal parameters including gestational age, fetal presentation, mode of delivery, birth weight, sex, Apgar score, age at onset of respiratory distress, treatment and outcome were observed.Results: Out of 1121 admissions in NICU, 12% of inborn and 9.6% of outborn were with MSAF, out of which 34% developed MAS. Majority of neonates were observed to be males (73.6%), term neonates (67.2%), weight 2.5-3.5 kg (76.9%) with mean weight being 2.701 kg±0.558 kg and 16% mortality including 9 inborn and 11 outborn neonates. Mean age at onset of respiratory distress was 18.43 minutes±11.52 minutes. Neonatal outcome was significantly related to weight, APGAR score at 5 mins, and development of complications like MAS, hypoxic ischemic encephalopathy, necrotizing enterocolitis, acute renal failure and severe thrombocytopenia. Culture proven septicaemia was seen in 21.6% cases. Mean duration of stay in NICU was 6.48 days±0.54 days.Conclusions: MSAF has significant effect on perinatal outcome and close observation is required to prevent and treat complications thus reducing mortality.

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Recém-nascidos em líquido amniótico meconial: variáveis e intervenções

Revista Recien - Revista Científica de Enfermagem ◽

10.24276/rrecien2021.11.33.128-138 ◽

2021 ◽

Vol 11 (33) ◽

pp. 128-138

Author(s):

Lilia Cristina Pantoja de Araújo ◽

Angeline Do Nascimento Parente ◽

Ruan Matheus Silva de Freitas ◽

Andressa Tavares Parente ◽

Rosângela Santana Moraes ◽

...

Keyword(s):

Child Care ◽

Amniotic Fluid ◽

Gestational Age ◽

Medical Records ◽

Perinatal Asphyxia ◽

Neonatal Resuscitation ◽

Meconium Aspiration Syndrome ◽

Meconium Aspiration ◽

Early Neonatal Mortality ◽

Meconium Stained Amniotic Fluid

A asfixia perinatal, causada pela Síndrome de Aspiração Meconial, é uma das principais causas de mortalidade neonatal precoce em recém-nascidos de baixo risco e sem anomalias congênitas. O objetivo da pesquisa foi definir o perfil e a ocorrência de reanimação neonatal de recém-nascidos em Líquido Amniótico Meconial de uma maternidade de referência materno infantil. Estudo quantitativo, retrospectivo documental realizado com 47 prontuários de recém-nascido selecionados mediante a presença de Líquido Amniótico Meconial ao nascimento. Na amostra: 55,3% a termo; 51,5% do sexo masculino; 55,3% via parto cesáreo; 48,9% com peso adequado para a idade gestacional; 78,7% não precisou de Aspiração sob Visualização Direta da Traqueia. Índice de Apgar menor que 7 pontos no primeiro minuto de vida foram 93,6 %, mas com melhora no quinto minuto de vida. Observa-se a importância de conhecer o perfil destes neonatos para proporcionar um atendimento qualificado.Descritores: Líquido Amniótico, Mecônio, Recém-Nascido. Neonates born through meconium stained amniotic fluid: variables and interventionsAbstract: Perinatal asphyxia, caused by Meconium Aspiration Syndrome (MAS), is one of the main causes of early neonatal mortality in low risk newborns and without congenital abnomalities. The goal of this research was to define the profile and the occurrence of neonatal resuscitation of neonates born on Meconium Stained Amniotic Fluid (MSAF) in a maternal hospital child care reference. This is a quantitative, retrospective documentary study performed based in 47 medical records of newborns selected through the presence of Meconium Stained Amniotic Fluid (MSAF) at the birth. In the specimen it was found that: 55.3% were born at term; 51.5% were male; 55.3% by way of cesarean; 48.9% with adequate weight for gestational age (AGA); 78.7% did not need aspiration under Direct Tracheal Visualization. It was identified that 93.6% had an Apgar score less than 7 points in the first minute of life, but with improvement in the fifth minute of life. It is noted the importance of knowing the profile of these newborns to provide qualified care.Descriptors: Amniotic Fluid, Meconium, Newborn. Recién nacido en líquido amniotico meconial: variables e intervencionesResumen: La asfixia perinatal, causada por el Síndrome de Aspiración Meconial, es una de las principales causas de mortalidad neonatal temprana en recién nacidos de bajo riesgo y sin anomalías congénitas. El objetivo de la investigación fue definir el perfil y la ocurrencia de la reanimación neonatal de recién nacidos en líquido amniótico meconial en un hospital de maternidad de referencia materno-infantil. Estudio cuantitativo, retrospectivo documental realizado con 47 registros médicos de recién nacidos seleccionados mediante la presencia de líquido amniótico meconial al nacer. En la muestra: 55,3% a término; 51.5% eran de género masculino; 55.3% por cesárea; 48,9% con peso adecuado para la edad gestacional; 78.7% no necesitaron aspiración mediante visualización directa de las traqueas. 93,6% presentaron puntuación de Apgar inferior a 7 puntos en el primer minuto de vida, pero con una mejora en el quinto minuto de vida. Se destaca la importancia de conocer el perfil de estos recién nacidos para proporcionar atención calificada.Descriptores: Líquido amniótico, Meconio, Recién Nacido.

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Influence of foetal inflammation on the development of meconium aspiration syndrome in term neonates with meconium-stained amniotic fluid

PeerJ ◽

10.7717/peerj.7049 ◽

2019 ◽

Vol 7 ◽

pp. e7049 ◽

Cited By ~ 2

Author(s):

Kyoko Yokoi ◽

Osuke Iwata ◽

Satoru Kobayashi ◽

Kanji Muramatsu ◽

Haruo Goto

Keyword(s):

Amniotic Fluid ◽

Apgar Score ◽

Neonatal Intensive Care ◽

Meconium Aspiration Syndrome ◽

Univariate Logistic Regression Analysis ◽

Term Neonates ◽

Meconium Aspiration ◽

Independent Variable ◽

Male Sex ◽

Meconium Stained Amniotic Fluid

Background Meconium-stained amniotic fluid is observed in approximately 10–15% of all deliveries; however, only 5% of neonates with meconium-stained amniotic fluid develop meconium aspiration syndrome (MAS). Although foetal distress and subsequent sympathetic stimulation have been considered as the primary upstream events of MAS, this clinical complication sometimes occurs due to other pathologies, such as intraamniotic inflammation. The aim of this study was to investigate whether the incidence of MAS is associated with the presence of funisitis and chorioamnionitis in term neonates with meconium-stained amniotic fluid. Methods Between April 2013 and March 2015, a total of 95 term neonates with meconium-stained amniotic fluid, who were hospitalized at a neonatal intensive care unit, were enrolled in the study. The placenta and umbilical cord were histopathologically examined. Clinical variables and histopathological findings associated with the incidence of MAS were studied. Results A total of 36 neonates developed MAS. Univariate logistic regression analysis revealed that a heavier birth weight, male sex, 1-min Apgar score ≤ 7, funisitis (but not chorioamnionitis), and elevated acute-phase inflammatory reaction score were associated with increased incidence of MAS (all p < 0.05). The multivariate model comprised funisitis (OR = 5.03, 95% CI [1.63–15.5], 1-min Apgar score ≤ 7 (OR = 2.74, 95% CI [1.06–7.09], and male sex (OR = 3.4, 95% CI [1.24–9.34]. Conclusion In neonates with meconium-stained amniotic fluid, funisitis, as well as low 1-min Apgar score and male sex, was identified as an independent variable for MAS development. Intraamniotic inflammation might be involved in the pathological mechanisms of MAS.

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Clinical study of babies born through meconium stained amniotic fluid

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20190687 ◽

2019 ◽

Vol 6 (2) ◽

pp. 491 ◽

Cited By ~ 1

Author(s):

Shilpasri Y. M. ◽

Madhurya B.

Keyword(s):

Amniotic Fluid ◽

Mode Of Delivery ◽

Birth Asphyxia ◽

Fetal Monitoring ◽

Fetal Distress ◽

Fetal Outcome ◽

Meconium Aspiration Syndrome ◽

Meconium Aspiration ◽

Medical College ◽

Meconium Stained Amniotic Fluid

Background: Meconium stained amniotic fluid has been considered a sign of fetal distress and associated with poor fetal outcome, but others considered meconium passage by fetus is physiological phenomena and produce environmental hazards to fetus before birth. Such magnitude of different opinion was the object behind taking up of this study and aim was to find out incidence and effect of meconium in terms of morbidity and mortality.Methods: Two hundred babies born with meconium stained amniotic fluid considering the inclusion and exclusion criteria from December 2012 to June 2013 in the Department of Paediatrics, Cheluvamba hospital attached to Mysore Medical College and Research Institute, Mysore. Fetal monitoring, mode of delivery, Apgar score, birth weight, resuscitation of baby are noted. All babies followed-up up to 1st week of neonatal life.Results: In present study 200 babies born through meconium stained amniotic fluid was randomly selected-thin 37% and thick 63%. Major complications like birth asphyxia, meconium aspiration syndrome, early neonatal death seen in 5.5% (11 cases), morbidity in 37%, 12.5% in thin and 24.5% in thick MSAF. Causes of death were meconium aspiration syndrome in 3 cases, sepsis in 1 case, pneumonia in 1 case and birth asphyxia in 6 cases.Conclusions: Immediate airway management, need for suction and intubation should be guided by state of newborn rather than presence of meconium. Timely diagnosis and management of meconium stained amniotic fluid may improve fetal outcome. From present study authors conclude that MSAF adversely affect fetal outcome mostly by thick meconium.

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An observational study of meconium aspiration syndrome and its immediate outcome with relation to thick and thin meconium stained amniotic fluid

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20180553 ◽

2018 ◽

Vol 5 (2) ◽

pp. 552

Author(s):

Sushant Kumar ◽

Minni Rani Akhouri

Keyword(s):

Amniotic Fluid ◽

Neonatal Intensive Care ◽

Mode Of Delivery ◽

Birth Asphyxia ◽

Meconium Aspiration Syndrome ◽

P Value ◽

Meconium Aspiration ◽

Clinical Criteria ◽

The Mean ◽

Meconium Stained Amniotic Fluid

Background: Meconium-stained amniotic fluid (MSAF) accounts for approximately 10-15% of live births and Meconium aspiration syndrome occurs in 5% among infants born through MSAF. The purpose of this study was to evaluate the outcome in neonates with meconium aspiration syndrome with regard to thin and thick meconium. Methods: A prospective cohort study of inborn neonates was done from April 2016 to August 2017 admitted in neonatal intensive care unit, Department of Paediatrics and Neonatology, RIMS, Ranchi after obtaining written informed consent from the parents or guardian and diagnosis of MAS was made depending on the clinical criteria and its clinical outcome was observed. MAS babies were studied on the basis of thin and thick meconium stained amniotic fluid.Results: The mean birth weight in thin meconium was 2760±394. The mean APGAR score in thin meconium at 1 minute (3.57±1.01) and 5 minutes (5.57±1.62) was significantly more than thick meconium. The mode of delivery in thin meconium was commonly by cesarean section (76.9%). There was need for resuscitation in 46.1% in thin meconium neonates which was significantly higher than neonates born with thick meconium 6.6% (P value 0.000). The most common complication in thin meconium was birth asphyxia (69.2%), followed by ARF and septicemia. Death was significantly higher in neonates born with thin meconium (69.2%)as compared to thick (20%) with P value of 0.000Conclusions: Amniotic fluid with thin meconium may cause more respiratory and other complications in neonates than amniotic fluid with thick meconium. Hence proper diagnosis and timely intervention can reduce the morbidity and mortality in neonates with meconium aspiration syndrome.

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TO STUDY THE ASSOCIATION OF PERINATAL OUTCOME WITH MECONIUM STAINED LIQUOR IN TERM PREGNANCY IN A BUSY PERIPHERAL TERTIARY CARE HOSPITAL

10.36106/ijsr/3532550 ◽

2021 ◽

pp. 1-4

Author(s):

Preeti Pushpam ◽

Seema Seema ◽

Debarshi Jana

Keyword(s):

Heart Rate ◽

Birth Weight ◽

Caesarean Section ◽

Amniotic Fluid ◽

Apgar Score ◽

Fetal Heart Rate ◽

Fetal Heart ◽

Control Group ◽

Meconium Aspiration ◽

Meconium Stained Amniotic Fluid

Passage of meconium still remains an enigma to the obstetrician and equally worries the paediatrician. The presence of meconium in amniotic fluid is still believed to be a serious sign of intra –uterine fetal compromise which is associated with an increase in perinatal morbidity. Clear amniotic fluid on the other hand is regarded as a good sign of clinical reassurance to both the obstetrician as well as the pediatrician. The exact etiology of meconium stained amniotic fluid is unclear. In our study the mean gestational age of the meconium stained liquor group was 39.6 (+ 1.4) weeks and of the clear liquor group was 38.8 (+ 1.3) weeks. In our study , 32% of the cases in the meconium stained group had gestational age between 40 – 42 weeks in comparison to only 13% patients in the control group. Our study concluded that meconium stained amniotic fluid was more prevalent in primigravidas (59%).No significant co-relation was found between age and meconium stained amniotic fluid. There is a greater incidence of meconium stained amniotic fluid in the unbooked population. As per our study, 35% of the patients in the meconium stained group were unbooked compared to 11% of the population in the control group. Overall, 77% of the population was booked and 33 % were unbooked. In our study , 47% of the patients had thin meconium , 20 % had moderate and 33% of the patients had thick meconium. As per present study, there was a greater incidence of fetal heart rate abnormalities in the form of abnormal CTG in meconium stained group in comparison to the clear group. In the group with meconium stained liquor, 30% of the patients had fetal heart rate abnormalities whereas only 12% of the patients in the clear liquor group had fetal heart rate abnormalities. Meconium stained liquor is associated with increased rate of operative deliveries as per our study. In our study , we found that 46% of the patient in the MSAF group underwent caesarean section whereas in the clear liquor group , 25% of the patients underwent caesarean section. In the MSAF group 49% patients had vaginal delivery and 5% had instrumental delivery. From the present study , we concluded that the percentage of babies with Apgar score <7 at 1 minute in the meconium stained group was more compared to the clear liquor group. In our study 27% of the babies in the MSAF group had low Apgar scores compared to only 11% of the babies in the clear liquor group.73% of the babies in the MSAF group had Apgar score >7. No significant co-relation was noted between Apgar score at 5 minutes and meconium staining of liquor. 9% of the babies in the meconium stained group had Apgar score <7 at 5 minutes compared to 6% of controls. Majority(46%) of the babies had birth weight between 2.5 – 3.0 kg whereas a significant percentage of babies had birth weight below 2.5 kg (21%). Meconium stained amniotic fluid is associated with a greater number of SNCU admissions. In our study, 20% of the babies in the meconium stained group were admitted to the nursery in comparison to only 9% nursery admissions in the clear liquor group. In this study it was seen that meconium aspiration syndrome was prevalent in the thickly stained group than in thinly stained group. 80% of the babies having meconium aspiration were in the thick meconium group. Early neonatal death did not seem to be significantly associated with meconium stained amniotic fluid , as per our study. 3 out of 100 babies born in the meconium stained group died whereas there was no death in the clear group.

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