Adverse perinatal outcome and mode of delivery in patients with meconium stained amniotic fluid
Dr. Shelly Khillan, Dr. Jiten Dahra and Dr. Parneet Kaur
To evaluate the perinatal outcome and mode of delivery in patients with Meconium stained Amniotic Fluid (MSAF).
Material and Methods: This prospective observational study was carried out in Department of Obstetrics and Gynaecology, Government Medical College and Rajindra Hospital, Patiala, over a period of one year from January 2017 to December 2017. Total 4653 patients delivered over this time period. A total of 609 patients who had completed more than 37 weeks of gestation, with singleton pregnancies and cephalic presentations with meconium stained liquor were included in this study.
Results: Among 609 patients, 63.1% of patients were unbooked cases, 36.9% of patients had at least 3 visits to our institute. Nulli parous patients accounted for 66.2% of the cases. 29.2% cases were beyond 42 weeks of pregnancy. 21.8% patients were of pregnancy induced hypertension. 20.2% patients were of oligo hydramnios, 10.2% patients were of Gestational Diabetes mellitus. In grade I MSAF 10.1% patients had abnormal CTG pattern, in Grade II MSAF 20.4% patients had abnormal CTG pattern, in Grade III MSAF 46.7% patients had abnormal CTG pattern. In grade I MSAF 26.4% patients delivered with LSCS, in grade II MSAF 45.7% patients delivered with LSCS, in Grade III MSAF 81.5% patients were delivered with LSCS. In patients with Grade I MSAF 14.1% babies were admitted to Neonatal intensive care unit, in Grade II MSAF 18.1% babies were admitted to Neonatal intensive care unit, in grade III MSAF 42.4% babies were admitted to Neonatal intensive care unit.
Conclusion: Meconium stained amniotic fluid is really worrisome from both, obstetrician's and paediatrician's point of view, as it increases the caesarean rates, causes birth asphyxia, Meconium Aspiration Syndrome [MAS] and increase in neonatal intensive care unit admissions.