Risk factors for meconium stained liquor and outcome of neonate in meconium stained amniotic fluid

• Author Details:   
• K. Subba Rao
• Sravanthi Pathapati
• Cheedi Vansipriya

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Background and Objectives: Meconium stained amniotic fluid has been considered a sign of fetal distress in presentations other than breech and associated with poor fetal outcome but others considered meconium passage by fetus as physiological phenomenon and produces environmental hazards to fetus before birth.
Such magnitude of different opinion was the object behind taking up of this study and aim of it was to find out the maternal risk factors associated and its correlation with the fetal outcome in terms of morbidity and mortality.
Methods: 100 women in labour with meconium stained amniotic fluid studied considering the inclusion criteria in the Department of Obstetrics and Gynecology, Konaseema Institute of Medical Sciences and Research Center, Amalapuram. Cases divided into two -‘thin’ and ‘thick’ meconium stained group. Maternal and Fetal monitoring, uterine contraction assessed and Apgar score, birth weight, resuscitation of baby noted. All babies of both group followed up to first week neonatal life.
Results: In our study, among 100 cases, 45% of the cases had thin meconium and 55% had thick meconium. Increased incidence of meconium staining was seen in crossed dates. The other risk factors were hypertension, anemia, oligohydramnios, IUGR. 56% went in for cesarean section due to intrapartumfetal distress. Perinatal death was seen in 4 cases, one due to birth asphyxia and the other three due to MAS.
Interpretation and Conclusion: Infants with meconium aspiration syndrome are to be managed in NICU for close monitoring and vigorous treatment. Co operation and coordination of the obstetrician and pediatrician is required to prevent the perinatal morbidity and mortality.
Based on this study we conclude that meconium stained amniotic fluid is associated with increased incidence of caesarean section, low APGAR score, meconium aspiration syndrome and increased NICU admission.

Keyword: Meconium, Amniotic fluid, Antepartum, Intrapartum, Neonate