The study of meconium staining of amniotic fluid and foetal outcome

Bhagyashri Gavhane, Sarika Thakare, Sachin Wankhede


Background: This study was carried out to determine the effect of meconium stained amniotic fluid on mode of delivery and correlation of thick and thin meconium with foetal outcome.

Methods: This prospective observational study was carried out in the Department of obstetrics and gynecology, IGGMC Nagpur from September 2015 to August 2017. All pregnant women in labor with cephalic presentation with singleton pregnancy with meconium stained liquor irrespective of age, parity and stage of labor were enrolled in this study. 200 consecutive study subjects who fulfilled inclusion criteria were included in the study.

Results: Out of 200 cases of MSAF, thick meconium was seen in 53.5% cases and thin meconium constituted 46.5% of the cases. The mean gestational age in present study was 39.31 ± 0.89 weeks. Overall incidence of LSCS in meconium stained amniotic fluid is 65.5%. The thick Meconium stained grades had significantly higher NICU admissions when compared to the thin meconium grades (p<0.05). In present study, the total perinatal mortality was 4%.

Conclusions: MSAF were associated with higher rate of caesarean delivery. It causes birth asphyxia, MAS, increases NICU admissions and perinatal mortality.


Meconium staining of amniotic fluid, Foetal outcome

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Wiswell TE, Bent RC. Meconium staining and meconium aspiration syndrome. Pediatr Clin North Am. 1993;40:955-81.

Steer PJ, Eigbe F, Lissauer TJ, Beard RW. Inter relationships among abnormal cardiotocograms in labor, meconium staining of the amniotic fluid, arterial cord blood pH and Apgar scores. Obstet Gynecol. 1989;74:715-21.

Low JA, Pancham SR, Worthington O, Bolton RW. The incidence of fetal asphyxia in 600 high risk monitored pregnancies. Am J Obstet Gynecol. 1975;121:456-9.

Meis PJ, Hall M, Marshall JR, Hobel CJ. Meconium passage: a new classification for risk assessment during labour. Am J Obstet Gynecol. 1978;131:509-13.

Abramovici H, Brandes JM, Fuchs K ,Timor FI. Meconium during delivery, a sign of compensated fetal distress. Am J Obstet Gynecol. 1974;118:251-5.

Ahanya SN, Lakshmanan J, Morgan BL, Ross MG. Meconium passage in utero: mechanisms, consequences, and management. Obstet Gynecol Surv. 2005;60:45-56.

Hackey WE. Meconium Aspiration. In; Gomella TL, ed. Neonatology. 4th edition. Newyork; Lange Medical Books; 1999:507.

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

Ashfaq F, Shah AA. Effect of amnio in fusion for meconium stained amniotic fluid on perinatal outcome. J Pak Med Assoc. 2004;54:322-5.

Naqvi SB, Manzoor S. Association of meconium stained amniotic fluid with perinatal outcome in pregnant women of 37-42 weeks gestation. Pak J Surg. 2011;27(4):292-8 .

Debdas AK, Kaur T. Meconium stained liquor - reappraisal. J Obstet Gynaecol India. 1981;31:924-9.

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

Naveen S, Kumar SV, Ritu S, Kushia P. Predictors of meconium stained amniotic fluid: a possible strategy to reduce neonatal morbidity and mortality. J Obstet Gynecol India. 2006;56:514-7.

Gokhroo K, Sharma U, Sharma M. Various maternal factors responsible for meconium stained amniotic fluid. J Obstet Gynaecol India. 2001;52(6):40.

Sandhu SK, Singh J, Khura H, Kaur H. Critical evaluation of meconium staining of amniotic fluid and foetal outcome. J Obstet Gynaecol India. 1993;43:528-3.

Tayade S. The significance of meconium stained amniotic fluid–A cross sectional study in a rural setup. IJBAR. 2012;12(3):861-6.

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 Contracept Obstet Gynecol. 2016;5:813-7.

Becker S, Solomayer E, Doganet C. Meconium stained amniotic fluid-perinatal outcome and obstetrical management in a low risk suburban population. Eur J Obstet Gynecol Reprod Biol. 2007;132:46-50.

Mundhra R, Agarwal M. Fetal outcome in meconium stained deliveries. J clinical Diagnostic Research. 2013;7:2874-6.

Sunoo CS, Kosasa TB, Nakayama RT, Hale RW. The incidence of meconium aspiration in Hawaii. Hawaii Med J. 1993;52:290-3.

Benirschke K, Kaufmann P. Pathology of the human placenta. Springer-Verlag. 2000.

Nasreen B, Mehmood S, Munmun SA. Perinatal outcome associated with meconium stained amniotic fluid in pregnancy. J Pediatric Surg Bangladesh. 2013;4:44-9.

Espinheira MC, Grilo M, Rocha G, Guedes B, Guimaraes H. Meconium aspiration syndrome-the experience of a tertiary center. Portuguese J Pulmonol. 2011;17(2):71-6.

Wong WS, Wong KS, Chang A. Epidemiology of meconium staining of amniotic fluid in Hong Kong. Aust NZJ Obstet Gynaecol. 1985;25(2):90-3.

Patil KP, Swamy MK, Samatha K. A one year cross sectional study of management practices of meconium stained amniotic fluid and perinatal outcome. Obstet Gynecol India. 2006;56:128-30.

Sasikala A, Raghavan S, Mishra N, Khatoon S, Bupathy A, Rani R. Perinatal outcome in relation to mode of delivery in meconium stained amniotic fluid. Indian J Pediatr. 1995;62(1):63-7.

Gregory SC. Correlation of meconium stained amniotic fluid, early intrapartum fetal pH and Apgar scores as predictors of perinatal outcome. Obstet Gynecol, 1980;56(5):604‐9.

Goud P, Krishna U. Significance of meconium staining of amniotic fluid in labour. J Obstet Gynaecol India. 1989;39:523-6.

Jeena S, Singh S, Arya A. Perinatal outcomes associated with meconium stained non-vigorous babies in a tertiary centre of Uttarakhand. J Biomed Pharmaceut Res. 2014;3:81-7.

Narli N, Kirmi E, Satar M, Turkmen M, Halaza M, Yapicioglu H. Evaluation and management of neonates. Eastern J Med. 2001.

Meena Priyadarshini, Seetha P. Meconium stained liqour and its fetal outcome. A retrospective study. IOSR-JDMS. 2013;6(2): 27-31.

Bhide SS, Shendurnikar N, Aiyer S, Baxi SR. Neonatal outcome after meconium stained amniotic fluid. J Obstet Gynaecol India. 1994;48:933-5.

Gupta V, Bhatia BD, Mishra OP. Meconium stained amniotic fluid: antenatal, intrapartum and neonatal attributes. Indian Pedia. 1996;33(4):293-7.

Khatun M, Arzu J, Haque E, Kamal MAL, Mamun M, Khan M, et al. Fetal outcome in deliveries with meconium stained liquor. Bangladesh J Child Health. 2009;33:41-5.

Narang A, Nair PMC, Bhakoo ON, Vashisht K. Management of meconium stained amniotic fluid: A team approach. Indian Pediatr. 1993;30:9-13.

Sharma U, Gokhroo K, Sharma M. Perinatal outcome in meconium- stained amniotic fluid. As J Obstet Gynecol Pract. 2004;8(4):37-40.