Publication:

Study on various risk factors leading to meconium-stained amniotic fluid in pregnancy and its effects on labor

Background Meconium-stained amniotic fluid (MSAF) is a common intrapartum finding, particularly in term and post-term pregnancies, and is often regarded as a marker of fetal compromise. While meconium passage may occur as a physiological phenomenon reflecting fetal maturity, it can also signify intrauterine hypoxia and is associated with adverse maternal and neonatal outcomes. The presence of MSAF poses significant challenges in intrapartum management due to its association with abnormal cardiotocographic (CTG) patterns, increased operative delivery rates, and neonatal complications such as meconium aspiration syndrome (MAS). Identification of maternal and obstetric risk factors and assessment of fetal monitoring parameters are therefore crucial to optimize labor management and improve perinatal outcomes. Objectives were to evaluate maternal risk factors, CTG patterns, and perinatal outcomes in pregnancies complicated by MSAF.

Methods A prospective observational study was conducted in a tertiary care hospital over two years. Seventy women ≥34 weeks gestation with MSAF during labor were included. Meconium was classified as thin or thick. Continuous intrapartum CTG was interpreted using NICE 2017 guidelines. Maternal, intrapartum, and neonatal outcomes were analyzed.

Results Thin meconium was observed in 60% and thick meconium in 40% of cases. Pathological CTG patterns and cesarean section rates were significantly higher in thick meconium. Neonatal morbidity including low Apgar scores, respiratory distress, ICU admission, and meconium aspiration syndrome was more common in thick MSAF.

Conclusions Thick MSAF associated with abnormal CTG predicts adverse perinatal outcomes. Close intrapartum monitoring and timely intervention are essential.