Background: Meconium-stained amniotic fluid (MSAF) is a common intrapartum finding, especially in late-term and post-term pregnancies, and is often associated with fetal distress. Thick meconium is considered a stronger indicator of fetal compromise and may lead to increased operative deliveries and adverse neonatal outcomes.
Materials and Methods: This cross-sectional study was conducted at a tertiary care center from October 2024 to September 2025, after institutional ethics approval. A total of 120 women with singleton, term (?37 weeks), cephalic pregnancies were enrolled and divided into two groups: MSAF (n=60) and clear liquor (n=60). Cases with malpresentation, multiple gestation, congenital anomalies, IUGR, stillbirth, and maternal comorbidities were excluded. Fetal heart rate monitoring was performed using cardiotocography. Mode of delivery and neonatal outcomes (Apgar score, NICU admission, complications) were recorded. Data were analyzed using SPSS v23, with p<0.05 considered statistically significant.
Results: Most MSAF cases occurred at advanced gestational age, with 73.3% delivering at ?39 weeks and 38.3% beyond 40 weeks. Thick meconium was significantly associated with non-reassuring fetal heart rate patterns compared to thin meconium (69.2% vs 17.6%, p<0.001). Cesarean section rate was significantly higher in thick meconium (69.2%) than thin meconium (29.4%) (p=0.002), while vaginal delivery was more common in thin meconium (61.8% vs 23.1%, p=0.003). NICU admission was significantly higher in thick meconium cases (73.0% vs 38.2%, p=0.01). Although low Apgar scores (<7) were more frequent in thick meconium, this was not statistically significant. Uneventful neonatal outcomes were significantly higher with thin meconium (61.7% vs 26.9%, p=0.04), while complications such as MAS and respiratory distress were more frequent with thick meconium.
Conclusion: Thick meconium-stained amniotic fluid is strongly associated with fetal compromise, increased cesarean delivery, higher NICU admissions, and reduced uneventful neonatal outcomes. Differentiation between thin and thick MSAF is essential for risk stratification, timely obstetric intervention, and improved perinatal outcomes.
International Journal of Clinical Obstetrics and Gynaecology
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Research Journals