Published: 2022-08-29

The study of maternal factors and perinatal outcome in meconium-stained liquor

Zalak V. Karena, Geetha Bhat, Kavita Dudhrejiya, Deep Gorfad


Background: The presence of meconium-stained amniotic fluid (MSAF) is believed to be one of the surest signs of fetal distress in utero due to fetal hypoxia. The objective of the study is to determine the maternal factors, mode of delivery and perinatal outcome for meconium-stained liquor.

Methods: A prospective observational study of 500 women with term pregnancy having meconium-stained liquor during labour after spontaneous or artificial rupture of membranes from 01 October 2018 to 30 September 2019 were included in the study. Details regarding maternal risk factors and perinatal outcomes were studied.

Results: The women were classified into 2 groups according to the type of staining: thin group and thick group.8.6% of the women had more than one risk factor. Prolonged labour (6.4%), oligohydramnios (4.8%) and hypertension (7%) prevailed more compared to other factors and had a significant association with meconium-stained liquor (p value <0.05). In our study, higher caesarean section rate (82.44%) due to fetal distress in meconium-stained liquor women was present. Incidence of birth asphyxia was significantly higher in thick meconium compared to thin meconium. 15 cases had birth asphyxia and 27 babies had meconium aspiration syndrome. Perinatal morbidity of 6.41% was seen in thin meconium-stained group and 20.74% with thick meconium-stained group. Out of 500 cases of meconium-stained liquor, 29 cases had neonatal death and 30 cases of thick meconium-stained group had still birth.

Conclusions: Meconium-stained liquor significantly increased the neonatal morbidity and mortality. The "thickness" of meconium had a direct bearing on the neonatal outcome.


Meconium, Meconium aspiration syndrome, Perinatal morbidity, Perinatal mortality, Birth asphyxia, Still

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Walker J. Foetal anoxia. J. Obstet Gynecol. 1954;61:162-80.

Desmond MM, Moore J, Lindley JE. Meconium staining of the amniotic fluid – A marker of fetal hypoxia. Obstet Gynecol. 1957;9:91-103.

Katz VL, Bowes WA. Meconium aspiration syndrome; reflection on a murky subject. Am J Obstet Gynecol. 1992;166:171-8.

Ramin KD, Leveno KJ, Kelly MA, Carmody TJ. Amniotic fluid meconium: a fetal environmental hazard. Obstet Gynecol. 1996;87(2):181-4.

James D, Steer P, Weiner C. High risk pregnancy. 1st edition. Cambridge University Press. 1994.

Miller FC, Sacks DA, Yeh SY, Paul RH, Schifrin BS, Martin CB. Significance of meconium during labor. Am J Obstet Gynecol. 1975;122:573-80.

Shaikh EM, Mehmood S, Shaikh MA. Neonatal outcome in meconium-stained amniotic fluid-one year experience. J Pak Med Assoc. 2010;60(9):711-4.

Sandhu SK, Singh J, Khura H, Kaur H. Critical evaluation of meconium staining of amniotic fluid and foetal outcome. J Obstet Gynaecol India. 1993;43:528-3.

Gokhroo K, Sharma U, Sharma M. Various maternal factors responsible for meconium stained amniotic fluid. J Obstet Gynaecol India. 2001;52(6):40.

Hiremath PB, Gane B, Meenal C, Bansal N, Ragaramya. The management practices and outcome of meconium stained amniotic fluid. Int J Biol Med Res. 2012;3(3):2204-7.

Pendse V, Meconium MS. Stained liquor amnii: its significance and effect on fetal outcome. J Obstet Gynecol India. 1983;33:66-9.

Goud P, Krishna U. Significance of Meconium stained amniotic fluid in labour. J Obst Gynecol India. 1989;39:523-6.

Nayak AH, Dalal AR. Meconium staining of amniotic fluid significance and fetal outcome. J Obstet Gynaecol India. 1991;41:480-3.

Meis PJ, Hall M, Marshall JR, Hobel CJ. Meconium passage: a new classification for risk assessment during labor. Am J Obstet Gynecol. 1978;131(5):509-13.