Perinatal outcome in relation to mode of delivery in meconium stained amniotic fluid
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20220175Keywords:
Meconium, Perinatal outcome, Mode of delivery, APGARAbstract
Background: Meconium stained amniotic fluid is the movement of meconium in the uterus by the fetus during the ANC period or through labor. It has been speculated during the intrapartum and postpartum period as a factor affecting fetal wellbeing and considered as the hallmark symptom of imminent asphyxia. Aim and objectives of current study were to correlate the presence of meconium-stained amniotic fluid with the mode of delivery and perinatal outcome.
Methods: A total of 100 women were taken in the study in which meconium stained amniotic fluid and its relation with mode of delivery and neonatal outcome were observed for 2 years.
Results: A total of hundred cases were studied. Incidence of types of meconium found to be thin (25%), moderate (34%) and thick (41%). 76% of patients with thin meconium were delivered vaginally without any assistance with instruments, while 64.7% and 68.3% of cases with moderate to thick meconium respectively were delivered by LSCS. In the group of patients with APGAR score more than 7 at five minutes, there is more percentage of patients with thin MSL while in the group of patients with APGAR score less than 7, there is more percentage of patients with thick meconium. No cases of meconium aspiration syndrome were found
Conclusions: The types of meconium affect the mode of delivery and fetal outcome. There is no association between having a low birth weight and passage of meconium during labor. The severity of the type of meconium associated with APGAR might be due to severe hypoxia and severe form of nervous system depression leading to cardiovascular and respiratory depression and activation of the parasympathetic nervous system causing anal sphincter relaxation and passage of meconium.
References
Williams JW. Williams Obstetrics. 1st ed. New York, Appleton; 1903.
Poggi SH, Ghidini A. Pathophysiology of meconium passage into the amniotic fluid. Early human development. 2009;85(10):607-10.
Hutton EK, Thorpe J. Consequences of meconium stained amniotic fluid: What does the evidence tell us?. Early Human Develop. 2014;90(7):333-9.
Ghidini A, Spong CY. Severe meconium aspiration syndrome is not caused by aspiration of meconium. Am J Obstet Gynecol. 2001;185(4):931-8.
Fanaroff AA. Meconium aspiration syndrome: historical aspects. J Perinatol. 2008;28(3):S3.
Louis D, Sundaram V, Mukhopadhyay K. Predictors of mortality in neonates with meconium aspiration syndrome. Indian Pediatr. 2014;851(8):637-40.
Nath P. Meconium stained amniotic fluid: A correlation with mode of delivery and perinatal outcome. New Indian J Obstet Gynecol. 2018;4(2): 158-60.
Carr BL. Differences in meconium stained amniotic fluid in an Australian population: A retrospective study. Women Birth. 2018;45(1):23-9..
Mundhra R, Agarwal M. Fetal Outcome in Meconium Stained Deliveries. J Clin Diagn Res. 2013;7(12): 2874-6.
