Background: Meconium stained amniotic fluid (MSAF) is a predictor of potential adverse fetal outcome. However, all fetuses with meconium passage do not have an adverse outcome. MSAF has been found to have significant association with an abnormal cord pH and lactate levels. Hence this study was undertaken to study the grades of MSAF and its effect on intrapartum management and relation with neonatal outcome.
Materials and Methods: A total of 126 subjects detected with MSAF after spontaneous or artificial rupture of membranes were enrolled in the study and were divided into two groups [Thin MSAF and Thick MSAF]. Association of various maternal high risk factors, fetal heart rate abnormalities, mode of delivery, cord blood parameters [pH and lactate] and neonatal outcomes were evaluated in relation to different grades of meconium staining.
Results:It was observed that thick MSAF was associated with abnormal cord blood parameters [High Lactate in 76.43% and low pH levels in 73.32%] in comparison to thin meconium [High Lactate in 30.28% and low pH in 26.66%]. Most common high risk factor for MSAF was post dated pregnancy. Subjects with thick MSAF had abnormal fetal heart rate pattern [70.45%], increased rates of LSCS [80.25%], low APGAR score [92.14%], increased need for resuscitation [86.10%], NICU admission [87.23%] and development of Meconium Aspiration Syndrome [12.77%] that was suggestive of poor perinatal and neonatal outcome.
Conclusion:Maximum subjects with thin MSAF had reassuring CTG and normal cord blood pH and lactate levels. Majority of them delivered vaginally with good neonatal outcomes. However presence of thick MSAF was associated with poor APGAR score, increased NICU admission and abnormal cord blood parameters.
International Journal of Clinical Obstetrics and Gynaecology
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