Maternal and Neonatal Outcome in Meconium Stained Amniotic Fluid at Term in Labour - A Retrospective Study

BACKGROUND Meconium stained amniotic fluid (MSAF) occurs in 12 - 15 % of all deliveries and is frequently associated with adverse outcome in pregnancy. The present study was carried out to find out the maternal and fetal outcome in pregnancy complicated by meconium stained liquor in labour METHODS This retrospective study was carried out at a tertiary care centre at Pune. A total of 340 cases who had meconium stained liquor during labour or was detected on amniotomy was analysed. RESULTS Out of 340 cases, 252 (74.1 %) had thin and 88 (25.9 %) had thick meconium. MSAF was detected more in early labour (244, 71.8 %), as compared to advanced labour (96, 28.2 %). 212 (84.13 %) patients with thin meconium delivered by vaginal route. 30 (34.09 %) patients with thick meconium delivered by vaginal route. 40 (15.87 %) patients with thin meconium delivered by LSCS and 58 (65.91 %) with thick meconium delivered by LSCS. This difference was statistically significant (< 0.001). Being multiparous was a protective factor both for mother and baby against the presence of MSAF. A majority of neonates, 199 (58.53 %) were asymptomatic at birth both in thin and thick MSAF group. Endotracheal suctioning was done in 101 (29.7 %) neonates in both groups. 40 neonates (11.77 %) were admitted to NICU for severe birth asphyxia. Meconium aspiration syndrome (MAS) was observed in 20 cases (5.88 %), out of which 18 (90 %) had thick meconium and 02 (10 %) had thin meconium. A total of 04 (1.18 %) neonatal deaths occurred due to MAS. They were born to primigravida, had induced onset of labour with detection of thick meconium and delivered vaginally. CONCLUSIONS Meconium stained amniotic fluid (MSAF) is associated with increased incidence of caesarean section, lower Apgar score, NICU admissions, development of meconium aspiration syndrome and neonatal death. Obstetrician should be more vigilant while dealing with cases of thick type of MSAF. A timely caesarean section improves the neonatal outcome. KEYWORDS Meconium Stained Amniotic Fluid (MSAF), Meconium Aspiration Syndrome (MAS)