Perinatal outcome of meconium stained liquor in pre-term, term and post-term pregnancy

• Author Details:   
• Pooja Gupta Jain
• Rakhi Sharma
• Meenu Bhargava

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Introduction: Meconium is a dark green liquid passed normally by the newborn baby containing bile, mucus & epithelial cells. The presence of meconium in amniotic fluid is of great concern to the obstetricians. It is a potential warning of fetal asphyxia but sometimes it may be physiological with no effect on fetus.
Objectives: To determine the prevalence of meconium stained liquor during labour associated risk factors and perinatal outcome in preterm, term and post term pregnancy.
Materials and Method: This is a observational prospective study done on the women coming to labour room and OPD for delivery. These women were examined and records were maintained in terms of their profile, time of rupture of membrane, appearance of meconium, mode of delivery, perinatal outcome, Apgar score and compared with control group.
Results: The incidence of MSL in our study is 11.01%(185 patients). There were 93 (50.2%) cases with thin staining (light green), 49 (25.9%) with moderately staining (yellow) and 44 (23.92%) with thick staining (deep green) liquor. No significant correlation was noted between maternal age and meconium staining of liquor but higher incidence of 11.6% was noted in women age group of >30 years. The incidence of staining was higher i.e. 17.1% in higher gestational age of fetus i.e. 41-42 weeks. Our study also yielded results of rising incidence of low –birth weight babies(less than 2.5kg) in meconium stained liquor cases. Instrumental vaginal deliveries (3.3%) and caesarean sections (44.6%) were found to be more prevalent in these cases. It was found that newborn with meconium stained liquor had significantly reduced APGAR scores at 1minute, 5minutes and 10 minutes(P<0.05) when compared to clear liquor cases. Meconium aspiration syndrome was more prevalent in the thickly stained group (3 patients) than in thinly stained group (zero patients). Mean Apgar Scores were significantly lower in cases complicated with thick stained liquor than in thin stained liquor or clear liquor. The incidence of admission to neonatal intensive care unit, meconium aspiration syndrome, neonatal deaths, instrumental vaginal and caesarean delivery were higher in pregnancies complicated by meconium stained liquor.
Conclusion: Meconium stained liquor is associated with advance maternal age, advance gestational age, increased caesarean section rate, lower apgar scoring, increased NICU admission rate and neonata.

Keywords: Meconium stained liquor, Amniotic fluid