Dinesh Bhasin1, Anish Kumar Vishal2, Biju Babu3, Anurakshat Bhasin4
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.
