A study of maternal and fetal outcome in meconium-stained amniotic fluid-a prospective hospital-based study

Aparna U. Dandale, Amarjeet Kaur Bava, Nikhil R. Shinde


Background: Meconium is a collection of secretions and desquamated cells from the digestive tract, and waste products from ingested amniotic fluid. It is a viscous, dark-green substance composed of intestinal epithelial cells, lanugo, mucus, and intestinal secretions. Intra uterine passage of meconium occurs in case of fetal distress; Important causes of in utero passage of meconium are oligohydramnios, placental insufficiency, preeclampsia.

Methods: The present prospective observational study is conducted at department of obstetrics and gynecology of tertiary care centre, Lokmanya Tilak municipal medical college and hospital, Mumbai. All antenatal women attending hospital in active phase of labour who fulfilled the inclusion criteria of single term pregnancy in cephalic presentation were included. A predesigned pretested interview schedule questionnaire was prepared in accordance with study objectives and was conducted in the language which they best understood. Permission was obtained from the institutional ethics committee. Maternal outcome: Increased incidence of cesarean and instrumental deliveries, wound infection, post-partum hemorrhage. Perinatal outcome: Birth asphyxia, meconium aspiration syndrome (MAS), respiratory distress syndrome (RSD), septicemia.

Results: Maximum women 71% were having gestational age of 37-40 weeks. most common maternal high-risk factors were post-dated pregnancy (29%) followed by oligohydramnios (19%). Deliveries by caesarean section were more (71.4%), most common indication being fetal distress (44.7%). Perinatal complications were birth asphyxia, MAS, RDS, low Apgar score.

Conclusions: Early identification of meconium-stained amniotic fluid (MSAF) in labouring women during intra-partum monitoring and availability of operation theatre for immediate intervention is required to reduce the perinatal morbidity and mortality.


Meconium, Oligohydramnios, Birth asphyxia

Full Text:



Locatelli A, Regalia AL, Patregnani C, Ratti M, Toso L, Ghidini A. Prognostic value of change in amniotic fluid color during labor. Fetal diagnosis and therapy. 2005;20(1):5-9.

Antonowicz I, Shwachman H. Meconium in health and in disease. Adv Pediatr. 1979;26:275-310.

Lucas A, Christofides ND, Adrian TE, Bloom SR, Aynsley-Green A. Fetal distress, meconium, and motilin. Lancet. 1979;313(8118):718.

Rossi EM, Philipson EH, Williams TG, Kalhan SC. Meconium aspiration syndrome: intrapartum and neonatal attributes. Am j obstetr gynecol. 1989;161(5):1106-10.

Walker J. Foetal anoxia. Int J Obstetr Gynaecol. 1954;61(2):162-80.

Ramin KD, Leveno KJ, Kelly MA, Carmody TJ. Amniotic fluid meconium: a fetal environmental hazard. Obstetr Gynecol. 1996;87(2):181-4.

James DK, Steer CP, Weiner B. Gonic. High risk pregnancy. 1st edition, Elsevier. 1994;1135-42.

Chang MY, Wang SY, Chen CH. Effects of massage on pain and anxiety during labour: a randomized controlled trial in Taiwan. J advanced nursing. 2002;38(1):68-73.

Rajput U, Jain A. Impact of meconium-stained amniotic fluid on early neonatal outcome. J Evolution Med Dental sci. 2013;2(45):8788-95.

Unnisa S, Sowmya BS, Rao SB, Rajagopal K. Maternal and fetal out come in meconium-stained amniotic fluid in a tertiary centre. Int J Reprod Contrac Obstetr Gynecol. 2016;5(3):813-7.

Mundhra R, Agarwal M. Fetal outcome in meconium-stained deliveries. J clin diagnostic res. 2013;7(12):2874.

Priyadharshini M, Panicker S. Meconium-stained liquor and its fetal outcome-retrospective study. IOSR-JDMS. 2013;6(2):27-31.

Bhatia P, Reena K, Nangia S. Role of intrapartum transcervical amnioinfusion in patients with meconium-stained amniotic fluid. J Obstetr Gynecol India. 2013;63(1):59-63.