A comparative study on feto-maternal outcome in patients with meconium stained liquor versus clear liquor

Authors

  • Kalpesh Patel Department of Obstetrics and Gynaecology, RNT Medical College, Udaipur, Rajasthan, India
  • Radha Rastogi Department of Obstetrics and Gynaecology, RNT Medical College, Udaipur, Rajasthan, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20214318

Keywords:

Meconium stain, Chronic hypoxia, Asphyxia, Antenatal care

Abstract

Background: Meconium is sterile, thick, black-green, odourless material, formed by accumulation of debris in the fetal intestine. This meconium, when leaks out intra-natally, due to hypoxia, can change the whole scenario, increasing intra-natal foetal risk, morbidity, and possibly causing mortality, depending upon the operative factors. Aims and objectives were to know the perinatal outcome in patients with meconium stained amniotic fluid. To study the complications of meconium stained amniotic fluid in the neonates.

Methods: Reverse-transcription polymerase chain reaction (RTPCR) negative women, gestational age >37 weeks with cephalic presentation and singleton pregnancy with meconium stained liquor (grade I, II, and III) after spontaneous or artificial rupture of membranes during labour. Delivery was expedited, when fetal heart rate abnormalities were detected, by safest mode of delivery. The Apgar score of neonates, neonatal intensive care unit (NICU) admission, number of days of hospitalization and birth asphyxia were recorded.

Results: A Total 11 patients with pre-eclampsia which presented with meconium stained liquor (MSL). 6 patients with prolonged labour presented with MSL. 8 had thin, 15 had thick MSL and 3 patients of clear liquor. 2 children developed persistent pulmonary hypertension of the newborn (PPHN) in case of MSL group. 25 children required oxygen support and antibiotics after delivery. Mean hospital stay was 2.81 days in MSL and 1.33 days in clear liquor group.

Conclusions: Chronic hypoxia is more damaging and dangerous than acute hypoxia, due to longer time it has continued the damage. This can be very effectively achieved by improving the Antenatal care, and intra natal vigilance. Proper monitoring of patients in intrapartum period of following parameters like fetal heart sound, uterine contractions, fetal movements.

References

Walker J. Fetal distress. Am J Obstet Gynecol 1959;77:94-8.

Fenton AN, Steer CM. Fetal distress. Am J Obstet Gynecol. 1962;83:354-9.

Wong SF, Chow KM, Ho LC. The relative risk of foetal distress in pregnancy associated with meconium stained liquor at different gestations. AMJ Obstet Gynaecol. 2002;22:594-9.

Hackey WE. Meconium Aspiration. In: Gomella TL. Neonatology. 4th Edition. New York; Lange Medical Books. 1999;507.

Steer PJ, Daniethian P. Foetal distress in labour. In: James DK, Steer PJ, Weiner CP, Gonaik B editors. High risk pregnancy: management options. 3rd edition. Philadelpia: Elsevier Inc. 2006:1450-72.

Tybulweicz AT, Clegg SK, Fonte GJ Stenson BJ. Preterm meconium staining of the amniotic fluid: associated finding and risk of adverse clinical outcome. Arch Dis Child Foetal Neonatal Ed. 2004;89:328-30.

Nathan L, Leveno KJ, Carmody TJ, Kelly MA, Sherman ML. Meconium: a 1990s perspective on an old obstetric hazard. Obstet Gynecol. 1994;83:329-32.

Nayek AH, Dalal AR. Meconium staining of amniotic fluid–significance and fetal outcome. J Obstet Gynaecol. 1991;41:480-3.

Miller FC, Sacks DA, Yeh SY, Paul RH, Schifrin BS, Martin CB, Hon EH. Significance of meconium during labor. Am J Obstet Gynecol. 1975;122:573-80.

Shaikh EM, Mehmood S, Shaikh MA. Neonatal outcome in meconium stained amniotic fluid – one year experience. J Pak Med Assoc. 2010;60:711-4.

Debdas AK, Kaur T. Meconium stained liquor - Reappraisal. Journal of Obstetrics and Gynaecology of India 1981; 31:924-9.

Downloads

Published

2021-10-27

Issue

Section

Original Research Articles