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Indian Journal of Maternal-Fetal & Neonatal Medicine

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Meconium Stained Amniotic Fluid Deliveries and Its Resulting Neonatal Outcome in a Tertiary Care Centre in Southern India

Vinitha Wills, Associate Professor, Department of Obstetrics and Gynaecology, Pushpagiri Medical Collge, Thiruvalla, Kerala 689101, India. , Jacob Abraham1 , Vinitha Wills2

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Indian Journal of Maternal-Fetal & Neonatal Medicine 5(1):p 17-23, January - June 2018. | DOI: DOI: http://dx.doi.org/10.21088/ijmfnm.2347.999X.5118.3

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Abstract

Context: Meconium stained amniotic fluid occurs as a result of foetal stress and therefore is considered to predict adverse foetal outcome, thus resulting in increased rate of operative deliveries.

Aims: To determine immediate foetal and neonatal outcome and associated maternal obstetric factors. Settings and

Design: Prospective observational study conducted in the Department of Obstetrics and Gynaecology and the Neonatology Unit in a tertiary care centre in Southern India. Methods and Material: Hundred pregnant mothers with meconium stained amniotic fluid delivered 102 babies. Maternal demographic details were noted and newborns were followed up tilldischarge. Their progress, complications and interventions were studied. Statistical analysis used: Frequencies and percentages of the various factors studied were determined.

Results: Among the 100 mothers, 66% were primigravida and 73% of mothers belonged to the younger age group of 21 – 30 years. Only 4% of the mothers were post term, but 73% delivered towards term (38 + to 40 weeks). The mode of delivery was mainly by Caesarean (64%). Among the babies, a majority (81.4%) were asymptomatic while only 18.6% required any respiratory support. Among the sick babies, 89.5% improved with oxygen therapy alone. Only two babies required endotracheal intubation in the delivery room and required further ventilatory support, and one was treated for shock. Only 27.4% of these babies required prolonged stay (> 72 hours) in the Neonatal Intensive Care Unit and majority (47.6%) required only short term antibiotics (3 days). Sepsis was suspected in 41.2% babies of which C Reactive Protein was positive in 16.6% while Blood culture positivity was there in 9.5 % of those screened for sepsis. Only 26.2% required antibiotics for longer than 5 days.

Conclusions: Meconium stained liquor is in itself, always not a determinant for adverse neonatal outcome. Other associated factors in a mother like hypertension complicating pregnancy, Intrauterine Growth Restriction and gestational diabetes also contribute to poor foetal outcome. Meticulous monitoring during labour and timely intervention for the mother by the obstetrician and immediate expert resuscitation results in better foetal outcome and brings down the perinatal morbidity in MSAF.

Keywords: Meconium Stained Amniotic Fluid (MSAF); Foetal Outcome; Neonatal Outome. 

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DOI: DOI: http://dx.doi.org/10.21088/ijmfnm.2347.999X.5118.3

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