Publication:

A study of meconium stained amniotic fluid, its significance and early maternal and neonatal outcome

Background Fetal well-being has traditionally been evaluated on the basis of fetal activity fetal heart and presence of meconium in liquor amnii in vertex presentation. The significance of meconium claimed to vary between its entirely being physiological to a sign of fetal distress. Passage of meconium is considered physiological exhibiting sign of fetal maturity on one hand & a sign of fetal distress and response to hypoxic insult on the other hand.

Methods The present study is a case-control study of meconium stained amniotic fluid, its significance and early maternal and neonatal outcome and was carried out in the department of Obstetrics & Gynecology, Dhiraj General Hospital, Pipariya during April 2011 to March 2012.

Results The incidence of passage of meconium was relatively higher in patients with pregnancy induced hypertension (20%) and pregnancy beyond 40 weeks (14.66%). Amongst the cases 28.66% patients had an abnormal fetal heart pattern and 12% had a variable fetal heart pattern whereas in controls the values were 8% and 3.33% respectively. The total number of patients with meconium aspiration was 18% whereas those with meconium aspiration syndrome were 6%.

Conclusions Meconium passage still remains an enigma to the obstetrician. However, as shown in the study, thick meconium or thin are indicative of fetal distress. If modern management is based on the understanding of underlying pathophysiology of meconium passage than the harmful effect of meconium can certainly be lessened.