International Journal of Clinical Obstetrics and Gynaecology

Introduction: Meconium-stained amniotic fluid (MSAF) is a frequent intrapartum finding that poses challenges in obstetric and neonatal management. While it may indicate fetal maturity, its association with hypoxia and meconium aspiration syndrome (MAS) makes it a significant cause of perinatal morbidity and mortality, especially in resource-limited settings.

Objectives: To determine the incidence, determinants, and neonatal outcomes associated with MSAF among women in labor at a tertiary care hospital in Eastern India.

Methodology: This prospective observational study was conducted on 1,572 laboring women at North Bengal Medical College and Hospital, Darjeeling, from February 2020 to July 2021. Demographic, obstetric, and clinical data were recorded. Meconium-stained liquor was classified as thin or thick, and associations with maternal and neonatal parameters were analyzed using Chi-square and Z-tests.

Results: The incidence of MSAF was 3.3%, with 59.6% of cases showing thick meconium. Significant associations were found with rural residence, low socioeconomic status, hypertension, anaemia, and post-term pregnancy (p<0.05). Emergency caesarean section was required in 55.8% of cases. Neonatal complications included MAS (19.2%), jaundice (7.7%), and early neonatal death (1.9%). Thick meconium was associated with higher SNCU admissions and longer hospital stays.

Conclusion: Although the overall incidence of MSAF was low, thick meconium and associated maternal comorbidities significantly increased the risk of adverse neonatal outcomes. Vigilant intrapartum monitoring, timely obstetric intervention, and prompt neonatal care are essential for optimizing fetomaternal outcomes.