Publication:

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

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.