DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20160590

Maternal and fetal out come in meconium stained amniotic fluid in a tertiary centre

Sadiq Unnisa, Sowmya B.S., Smitha B. Rao, Rajagopal K.

Abstract


Background: This study was undertaken to determine the correlation of amniotic fluid stained with meconium (MSAF) with maternal and fetal outcome.

Methods: This prospective observational study was carried out in the Department of obstetrics and gynecology, Yenepoya medical college, Mangalore over a period of 14 months between January 2013 to march 2014. A total of 1000 pregnant women who had completed more than 37weeks of gestation with singleton pregnancies & cephalic presentation were included in this study. MSAF on spontaneous or artificial rupture of membranes were monitored during labour with fetal heart rate abnormality, consistency of liquor, 1 minute and 5 minute Apgar score, LSCS, instrumental delivery, NICU admissions and neonatal complications as outcome variables.

Results: Women were divided into two groups: 350 women with MSAF as cases, while 650 women with clear liquor were taken as controls. Among 350 cases with MSAF, 70 % were unbooked and 30 % were booked pts. About 75.7% of women were between 20-30 years of age-group. Primi gravidas constituted 51.4% in study group. Approximately 41.4% cases had gestational ages of 39 -39+6. Among MSAF 55.4% were thin stained & 44.5%were thickly stained. 45.7% showed fetal heart abnormalities on electronic monitoring & presence of fetal bradycardia was higher. Caesarean section rates were nearly triple in cases (45.7% vs 15.7%). Fetal out come in regard to Apgar score at birth, birth asphyxia, MAS, increased NICU admissions were more in cases. Incidence of Male to female was high (52.6% vs 47.3%).

Conclusions: Presence of MSAF is worrisome for both the obstetrician and pediatricians view as it increases surgical intervention, birth asphyxia, MAS & NICU admissions.

Keywords


Meconium stained liquor, Term gestation, Apgar score birth asphyxia, MAS

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References


Wood CL. Meconium stained amniotic fluid J Nurse Midwifery. 1994;39(2 Suppl):106S-9S.

Katz VL, Bowes WA Jr. Meconium aspiration syndrome: reflections on a murky subject. Am J Obstet Gynecol. 1992;166:171-83.

Mitchell J, Schulman H, Fleischer A. Meconium aspiration fetal acidosis. Obstet Gynecol. 1985;65:352-5.

Steer PJ, Eigbe F, Lissauer TJ, Beard RW. Interrelationships among abnormal cardiotocograms in labor, meconium staining of the amniotic fluid, arterial cord blood pH, and Apgar scores. Obstet Gynecol. 1989;74(5):715-21.

Shaik EM, Mehmood S, Shaik MJ. Neonatal outcome in meconium stained amniotic fluid-one year experience. J PakMed Assoc. 2010;60(9):711-4.

Fleisher A, Anyaeghunam A, Guidetti D, Randolph G, Merkartz IR. Persistant clinical problem:profile of the term infant with significant respiratory complications. obstet Gynecol. 1992;79:185-90.

Berkus MD, Langer O, Samueloff A, Xenakis EM, Field NT, Ridgway LE. Meconium-stained amniotic fluid: increased risk for adverse neonatal outcome. Obstet Gynecol. 1994;84(1):115-20.

Ratnam SS, Bhaskar Rao K, Arulkumaran S. Practical approach to Intrapartum fetal monitoring in labour. Chapter 12. Obstetrics and Gynecology for Postgraduates. 1992;1:115-25.

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

Mukhopadhyay PN, Dalui R, Hazra S. Role of Intrapartum amnioinfusion in meconium stained amniotic fluid. The Journal of Obstetrics and Gynaecology of India. 2006;563:230-2.

Klinger M C, Kruse J. Meconium aspiration syndrome: pathophysiology and prevention. J Am Board Fam Med.1999;12(6).

Cleary GM, Wiswell TE. Meconium-stained amniotic fluid and the meconium aspiration syndrome. An update. Pediatr Clin North Am. 1998;45:511-29.

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.

Bhide SS, Shedurnikar N, Aiyer S, Baxi SR. Neonatal outcome after meconium stained amniotic fluid. J Obstet Gynecol India. 1993;44:933-5.

Sandhu SK, Singh J. Critical evaluation of meconium staining of amniotic fluid and fetal outcome. . J Obstet Gynecol India. 1993;43:528-53.

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

Sedaghatian MR, Otheman L, Rashid N, Ramachandran P, Bener BA. An 8 year study of meconium stained amniotic fluid in different ethnic groups. Kuwait Medical Journal. 2004;36:266-9.

Becker S, Solomayer E, Dogan C, Wallwiener D, Fehm T. Meconiun stained amniotic fluid perinatal outcome and obstetrical management in low –risk sub urban population. Eur J Obstet Gynecol Reprod Biol. 2007;132(1):46-50. .

Saunders K. Should we worry about meconium? A controlled study of neonatal outcome. Trop Doct. 2002;32(1):7-10.

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.

Rossi EM, Philipson EH, Williams TG, Kalhan SC. Meconium aspiration syndrome: Intrapartum and neonatal attributes. Am J Obstet Gynecol. 1998;10:107-27.

Khatun M, Arzu J, Haque E, Kamal M, Manum M, Khan M. Fetal out come in deliveries with meconium stained liquor, Bangladesh J child health. 2009;33:41-5.