Perinatal and maternal outcome in meconium stained amnioticfluid (thin and thick) at dhiraj general hospital, a rural tertiary health centre
Keywords:Meconium stained liquor, Meconium aspiration syndrome, Birth asphyxia, Hypoxic ischemic encephalopathy
Background: To determine the perinatal outcome of with Meconium-stained amniotic fluid (MSAF) compared with clear amniotic fluid at Dhiraj Hospital.
Methods: A prospective observational study was carried out in obstetrics and gynaecology department of Dhiraj Hospital, Sumandeep Vidyapeeth from March 2021 to August 2021. All patients fulfilling inclusion and exclusion criteria as mentioned above were taken for the study. All the categorial variables were analysed independently with the help of chi square test and fisher’s exact test and all the continuous variables were analysed with independent ‘t test’.
Results: Out of 500 patients selected for the present study which had inclusion criteria, 13.6% were meconium stained out of which 50 (73.5%) cases had thin meconium and 18 (26.4%) cases had thick meconium. Fetal CTG abnormalities were more common in MSAF group and were noted in 38.2% of cases which is significantly increased compared to control group with CTG abnormalities in 8.3%. The difference was significant with p value of <0.001. 32(47.0%) patients with meconium-stained amniotic fluid had normal vaginal delivery, while in control group out of 432, 360 (83.3%) delivered normally. Incidence of LSCS and assisted vaginal delivery was more in meconium-stained amniotic fluid.
Conclusions: Meconium-stained amniotic fluid is associated with more frequency of operative delivery, birth asphyxia, neonatal sepsis, and neonatal intensive care unit admissions compared to clear amniotic fluid. Better perinatal outcome in clear amniotic fluid compared to meconium stained liquor.
Mundhra R, Agarwal M. Fetal outcome in meconium stained deliveries. J Clin Diagn Res. 2013;7(12):2874.
Wong S, Chow K, Ho L. The relative risk of fetal distress' in pregnancy associated with meconium-stained liquor at different gestation. J Obstet Gynaecol. 2002;22(6):594-9.
Monen L, Hasaart T, Kuppens S. The etiology of meconium-stained amniotic fluid: pathologic hypoxia or physiologic foetal ripening?. Early Human Develop J. 2014;90(7):325-8.
Lee J, Romero R, Lee KA, Kim EN, Korzeniewski SJ, Chaemsaithong P, et al. Meconium aspiration syndrome: a role for fetal systemic inflammation. Am J Obstet Gynecol. 2016;214(3):366. e1-9.
Singh G, Singh O, Thapar K. Neonatal outcome in meconium stained amniotic fluid: a hospital based study. Int J Contemp Pediatr2017;4:356-60.
Qadir S, Jan S, Chachoo JA, Parveen S. Perinatal and neonatal outcome in meconium stained amniotic fluid. Int J Reprod Contracept Obstet Gynecol. 2016;5: 1400-5.
Addisu D, Asres A, Gedefaw G, et al. Prevalence of meconium stained amniotic fluid and its associated factors among women who gave birth at term. BMC Pregnancy Childbirth. 2018;18:429.
Vaghela HP, Deliwala K, Shah P. Fetal outcome in deliveries with meconium stained liquor. IJRCOG. 2014;45:52.
Divia A. Study on risk factors and perinatal outcome in meconium-stained liquor in IOG. Madras Med Coll J. 2018:41:54-9.
Adda AB. Factors influencing meconium stained amniotic fluid (msaf) delivery outcomes at ridge hospital, Accra. Univ Ghana J. 2017;45:52-9.
Patil K, Swamy M, Samatha K. A one year cross-sectional study of management practices of meconium-stained amniotic fluid and perinatal outcome. Obstet Gynecol India. 2006;56:128-30.
Gupta V, Bhatia BD, Mishra OP. Meconium stained amniotic fluid: Antenatal intrapartum and neonatal attributes. Indian Paediatr. 1996;33:293-7.