TO STUDY MATERNAL RISK FACTORS & PERINATAL OUTCOME IN MECONIUM STAINED AMNIOTIC FLUID

Introduction: Meconium is a sterile, thick, black - green, odourless material that results from accumulation of debris in fetal intestine during the third month of gestation. In the fetus, passage of meconium occurs physiologicall yearly in gestation, when it contributes to alka linephosphatasein amniotic fluid but diminishes after 16 weeks and ceases by 20 weeks, concurrent with innervation of the anal sphincter and the rectum appears to be filled with meconium. The risk factors for meconium-stained amniotic fluid (MSAF) are both maternal and fetal. Materials & Methods: This prospective, Observational, Single group and cross-sectional study was conducted in the Department of Obstetrics and Gynaecology in collaboration with the Department of Pediatrics at VIMS Ballari. After considering all the obstetrical conditions, the mode of delivery of the patients were noted down. Maternal risk factors were noted down. MSAF was further divided into three grades: grade I was thin yellow color meconium with no particulate matter, grade II was light green color with few particulate matters, and grade III was thick paste-like dark greencolored meconium with excess particulate matter. The condition of neonates, i.e., birth weight, Apgar score, general condition, need for admission in neonatal ICU, and neonatal complications and outcome was also be recorded. Results: The analysis of the age groups of the patients having meconium stained amniotic fluid showed that the most commonly affected age group was between 21-25 years (68%) followed by 26-30 years (18%) and 20 years or below (7%). The analysis of risk factors showed that 23 (23%) women had Hypertensive disorders of pregnancy risk factors are most common followed by Oligohydramnios (6%). The most common mode of delivery in meconium stained amniotic fluid was by LSCS (47%) followed by Full-Term Vaginal Delivery (41%) and Pre-Term Vaginal Delivery (12%). The analysis of the birth weights in the study showed that in that group <2 kg (6%) neonates while 27 (27%) babies were between 2.0-2.5 kg weight. While normal birth weight was seen in 2.6-3.0 kg (56%) neonates and 11 (11%) babies were >3.1 kg weight. Thick meconium stained liquor was more commonly associated with lower APGAR scores at 1 as well as 5 minutes than thin meconium stained liquor. The difference was found to be statistically significant (P<0.05). Conclusion: Meconium stained amniotic fluid is worrisome as it is associated with increased frequency of operative delivery, birth asphyxia, neonatal sepsis, and neonatal intensive care unit admissions compared to clear amniotic fluid which was seen in the current study.