Obstetrics Outcome at Term in Meconium Stained Amniotic Fluid – a Retrospective Study

Objective-The purpose of this study was to find out prevalence ,risk factors, mode of delivery, & perinatal out come in Meconium stained amniotic fluid (MSAF) during delivery At term pregnancy.Study design-this retrospective study was conducted in MGMC&RI,puducherry with womens at 37-42 wks of gestation those were meconium stained amniotic fluid during labour & delivery.Different maternal outcome like mode of delivery,indication for operative delivery & perinatal outcome in relation to low apgar score,neonatal intensive care unit( Nicu) admission,meconium aspiration syndrome(MAS),perinatal asphyxia & neonatal death were analysed .Result— Prevalence of meconium stained amniotic fluid during labour & delivery was 12.42% during study period.Most of the cases were primigravida (85%) with mean age & gestational age of-24.99 yrs & 39.44 wks respectively. Postdated pregnancy (32.85%) & oligo hydramnios(18.57%) were the two major risk factor for meconium stained amniotic fluid.Caesarean section (C.S) was the most common mode of delivery (84.28%) due to fetal distress & thick meconium stained liquor(40.71%).20% of cases were admitted to Nicu for low apgar score at birth.50% of nicu admission were due to MAS & its complication.There were two(7.14% of nicu admission) neonatal death due to MAS & its complication inspite of early active intervention in our study. Conclusion-Meconium stained amniotic fluid during labour & delivery is definite direct & indirect evidence of fetal distress(FD) .Grading of meconium stained amniotic fluid was a severe adverse effect in perinatal outcome. Instead of early active intervention there were early neonatal death in our study. So the outcome of meconium stained amniotic fluid during labour & delivery is unpredictable. KEYWORDS—Meconium stained amniotic fluid.,Meconium aspiration syndrome,Fetal distress,Caesarean section, Neonatal intensive care unit. *Corresponding author DR A.K.MAHAPATRO Asst. Prof. Dept. of obgy, MGMC&RI, puducherry. Int J Pharm Bio Sci 2014 April ; 5 (2) : (B) 866 871 This article can be downloaded from www.ijpbs.net B 867 INTRODUCTION Meconium ,the first sterile intestinal discharge of new born, is a viscous dark green substance composed of intestinal epithelial cells,lanugo,mucus,biles,mucosal cells & solid elements of swallowed Amniotic fluid.Meconium is rarely found in AF prior to 34 wks. Usually neonate passes meconium soon after birth but under stress fetus passes meconium while still inside the uterus. Presence of meconium stained amniotic fluid( MSAF) is a sign of fetal compromise & increased chance of perinatal morbidity. Risk factors that may cause stress on the fetus which lead to MSAF are --: placental ageing due to postdated pregnancy,Iugr, oligohydramnios, hypertensive disorder of pregnancy,GDM , overt diabetes melitus & maternal drug abuse . Meconium may be aspirated before or during labour & delivery resulting in neonatal RDS.. Prevalence of Meconium stained amniotic fluid varying between 7-22% of live births 1 . Prevalence of MAS is about 1.8%-18% in infants delivered from MSAF . There are contradictory studies about the effect of MSAF on obstetrics outcome.So this present study was conducted with the objective to find out prevalence, association of risk factor & mode of delivery & perinatal outcome in patients having meconium stained amniotic fluid during labour & delivery.