Study of risk factors and perinatal outcome in meconium stained deliveries from a district of Uttar Pradesh, India
Keywords:Birth asphyxia, Meconium aspiration syndrome, Meconium stained amniotic fluid
Background: The objective is to identify the risk factors of Meconium stained deliveries and evaluate the perinatal outcomes in Meconium Stained deliveries.
Methods: This prospective observational study included those pregnant women who had completed 37 weeks of gestation, with singleton pregnancies with cephalic presentations and with no known fetal congenital anomalies. Among these, we selected 110 cases with Meconium stained amniotic fluid and they were compared with 110 randomly selected controls.
Results: Regular antenatal visits were seen in 22.73 % of the cases while 77.27% cases had no previous visit. Majority of cases were primigravida and gestational ages of >40 weeks was seen in 55.45 % cases. 19.09% cases had meconium staining among pregnancies complicated with pregnancy induced hypertension, as compared to those among controls (5.45%). Fetal heart rate abnormalities were seen in 29.09% cases, and statistically significant fetal bradycardia was seen in cases. Caesarean section rates were nearly double in cases (54.55%). Poor perinatal outcome was found in cases as seen in results by low Apgar score (<7) at 1 minute and 5-minute, higher incidence of birth asphyxia, Meconium Aspiration Syndrome and increased NICU admission as compared to that among controls.
Conclusions: Meconium stained amniotic fluid is more commonly associated with higher gestational age >40 weeks, pregnancy induced hypertension and fetal bradycardia, increased cesarean section rates, low APGAR score and higher incidence of birth asphyxia and NICU admissions. Meconium aspiration syndrome was associated with early neonatal death.
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