Meconium-Stained Amniotic Fluid during Labour and Fetal Outcomes

Abstract

Objectives: To determine the frequency of adverse fetal outcomes in labour with meconium stained amniotic fluid (MSAF). 

Methodology: This descriptive series study was conducted at Department of Gynaecology and Obstetrics, Qazi Hussain Ahmad Medical Complex Nowshera, Pakistan from Sept 2022 to March 2023. A total of 115 pregnant women with a term (>37 weeks gestation), singleton, uncomplicated pregnancy with cephalic presentation going through labour induction and had MASF were enrolled in the study through consecutive sampling. Presence of meconium staining was noted and recorded with its details. Primary outcomes were set as fetal outcomes in terms of 1 & 5 minutes Apgar score < 7, MAS, fetal distress, birth asphyxia, NICU admission and still birth. Daily follow up was done and a final follow up visit in OPD was made after 2-week time. Descriptive analysis was done by applying frequency and percentage.

Results: The mean age in this study was 29.6±5.35 years with an age range of 19-40 years while the Mean±SD of gestation was 39.73±1.27 weeks. Apgar< 7 at 1 min was observed in 29 (25.21%) patients, Apgar< 7 at 5 min was observed in 12 (10.43%) patients while MAS was observed in 12 (10.43%) of the patients. Other adverse fetal outcomes include fetal distress 28 (24.34%), asphyxia 15 (13.04%), NICU admission 28 (24.34%) and still birth 3 (2.6%). The incidence of adverse fetal outcomes was found more in patients with thick MSAF.

Conclusion:  MSAF leads to adverse fetal outcomes. Diagnosing the presence and degree of meconium staining will help in optimal management and will reduce the adverse fetal outcomes during labour.     

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