DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20205443

Perinatal outcome in meconium-stained amniotic fluid at term: a single center prospective study

Vandana Mohapatra, Sujata Misra, Tapas Ranjan Behera

Abstract


Background: The presence of meconium-stained amniotic fluid is a sign of fetal compromise and is associated with increased perinatal morbidity. The objective of this study was to determine the perinatal outcome in pregnant women at term with meconium-stained amniotic fluid (MSAF) and compare it with the outcome associated with clear liquor.

Methods: A prospective observational, study was conducted in the department of obstetrics and gynecology, VIMSAR, Burla from January, 2013 to June, 2013. Pregnant women with singleton pregnancy, cephalic presentation at term were included in the study. Total 135 cases of MSAF (study group) were compared with 165 randomly selected controls with clear liquor. Outcome measures were fetal heart rate (FHR) abnormality, mode of delivery, Apgar score, neonatal intensive care unit (NICU) admission, diagnosis of meconium aspiration syndrome (MAS), birth asphyxia and neonatal death. Statistical analysis was done by using the mean and Chi-square test with or without Yates’ correction. 

Results: The mean gestational age for meconium staining in the present study was 40.31±0.48 weeks. Caesarean section was the most common mode of delivery in MSAF group whereas vaginal delivery was most common in control group. Significantly higher number of babies in the study group required NICU admissions. The incidence of MAS and birth asphyxia too was statistically higher among babies born to study group as compared to control group.

Conclusions: MSAF has significant adverse effect on the perinatal outcome, as it increases the caesarean section rates, NICU admissions, MAS and birth asphyxia.


Keywords


Amniotic fluid, Fetal distress, Meconium, Perinatal outcome, Term pregnancy

Full Text:

PDF

References


Maymon E, Chaim W, Furman B, Ghezzi F, Shoham Vardi I, Mazor M. Meconium-stained amniotic fluid in very low risk pregnancies at term gestation. Eur J Obstet Gynecol Reprod Biol. 1998;80:169-73.

Ross MG. Meconium aspiration syndrome-more than intrapartum meconium. N Engl J Med. 2005;353(9):946-8.

Mundhra R, Agarwal M. Fetal outcome in meconium-stained deliveries. J Clin Diagnostic Res. 2013;7(12):2874-76.

Shaikh EM, Mehmood S, Shaikh MA. Neonatal outcome in meconium-stained amniotic fluid-one-year experience. J Pak Med Assoc. 2010;7(9):711-14.

Addisu D, Asres A, Gedefaw G, Asmer S. Prevalence of meconium-stained amniotic fluid and its associated factors among women who gave birth at term in Felege Hiwot comprehensive specialized referral hospital, North West Ethiopia: a facility based cross-sectional study. BMC Preg Childbirth. 2018;18:429.

Klinger MC, Kruse J. Meconium aspiration syndrome: pathophysiology and prevention. J Am Board Fam Pract. 1999;12(6):450-66.

Swarnam K, Soraisham AS, Sivanandan S. Advances in management of meconium aspiration syndrome. Int J Pediatr. 2012;7.

Bhatia P, Ela N. Fetal and neonatal outcome of babies in meconium-stained amniotic fluid and meconium aspiration syndrome. J Obstet Gynecol India. 2007;57(6):501-04.

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

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.

Patil KP, Swamyy MK, Samatha K. A one-year cross sectional study of management practices of meconium-stained amniotic fluid and perinatal outcome. J Obstet Gynecol of India. 2006;56(2):128-30.

Oyelese Y, Culin A, Ananth CV, Kaminsky LM, Vintzileos A, Smulian JC et al. Meconium-stained amniotic fluid across gestation and neonatal acid base status. Obstet Gynecol. 2006;108:345.

Edmond NM, Philip NN, Julienne SN, Julius SD, Evelyn M et al. Perinatal Outcome in Term Pregnancies with Meconium-Stained Amniotic Fluid in Two Referral Hospitals of Yaoundé- Cameroon. Biomed J Sci Tech Res. 2018;2(2).

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

Hiersch L, Krispin E, Aviram A, Wiznitzer A, Yogev Y, Ashwal E. Effect of Meconium-Stained Amniotic Fluid on Perinatal Complications in Low-Risk Pregnancies at Term. Am J Perinatol. 2016;33(04):378-84.

Becker S, Solomayer E, Dogan C, Wallweiner D, Fehm T. Meconium-Stained Amniotic fluid- perinatal outcome and obstetrical management in a low-risk suburban population. Eur J Obstet Gynecol Reprod Biol. 2007;132(1):46-50.

Sori DA, Belete A, Wolde M. Meconium-Stained Amniotic Fluid: Factors affecting Maternal and Perinatal Outcomes at Jimma University Specialized Teaching Hospital, South West Ethiopia. Gynecol Obstet. 2016;6(8):394.