Publication:

Duration of meconium-stained labor-prevalence and association with adverse maternal and neonatal outcomes

Background Meconium-stained amniotic fluid (MSAF) is the result of the passage of fetal intestinal contents by normal intestinal peristalsis of the mature fetus or by vagal stimulation in utero. It affects up to 9-20% of deliveries. The incidence of MSAF increases with gestational age from 31 weeks to the end of pregnancy. MSAF is known to be associated with neonatal adverse effects. To provide insight on the correlation between secondary Meconium stained amniotic fluid and adverse pregnancy outcomes including maternal and neonatal morbidities, compared with Primary MSAF.

Methods This was a prospective longitudinal observational study done at Fernandez Hospital, Hyderabad over a period of 1 year 5 months-Aug 2022 to Dec 2023. All women with Term gestation, singleton pregnancy, with spontaneous or induced labour, who were booked or referred delivering at Fernandez Hospitals and  were included in this study Sample size received during study was 500.

Results Secondary MSL was seen more to occur with  Primigravida  and Nulliparous women  (p=0.045).  Association of secondary MSL was found to be more with Induced labor whereas occurrence of Primary MSL was more seen in spontaneous labor (p=0.042). Complications such as PPH, Non-reassuring FHR were more in secondary MSL group and were statistically significant. Composite neonatal outcomes of Acidemia, low apgar at 1 min, Need for resuciation and Meconium aspiration were significant in secondary MSL Group.

Conclusions MSAF remains  a stigma. This study showed complications more with secondary MSL than Primary MSL. The findings would be useful in counselling couples in such case scenarios and make informed choices and help in decision making.