Abstract

Objectives: To assess the neonatal outcomes associated with the incidence of meconium-stained amniotic fluid (MSAF) in mothers who delivered at term.

Study Design: A case–control study design

Study Setting and Duration: The study was conducted at Obstetrics and gynecology Department, unit-2Kausar hospital Mother & Child Health Care Center Khairpur, Khairpur Medical College Khairpur Mirs for a duration of Eight months from Jan, 2020 to August, 2020.

Methodology: During the study period, a total of 73 cases with meconium stained amniotic fluid were recruited and 73 healthy subjects with clear amniotic fluid acted as control. Women with singleton pregnancies presented to the obstetrical department for delivery between 37 weeks to 42 weeks were included in the study. Women with breech presentation, congenital abnormality, twin births, stillbirth or preterm or late-term cases were excluded from the study. Participants with MSAF were labelled as group A and those with clear amniotic fluid were labelled as group B. A predefined questionnaire was used to recruit information on socio-demographic, obstetrical characteristics of mothers and neonatal outcomes. Data was analyzed using SPSS version 26.

Results: Prolonged labour of greater than 12 hours was more frequently observed in the MSAF group compared to the control healthy subjects with clear amniotic fluid. The rate of birth asphyxia in MSAF was 6.85% in the MSAF group compared to the 1.37% in the control group. One neonate in the MSAF group developed hypoxic-ischemic encephalopathy. Meconium aspiration syndrome - a lethal complication was more frequent in cases with MSAF during delivery. Other complications such as neonatal sepsis, transient tachypnea of the newborn (TTN) and respiratory distress syndrome were all more frequent in the MSAF group compared to the control group.

Conclusion: The current study highlights the association of meconium-stained amniotic fluid with poor neonatal outcomes including meconium aspiration syndrome, hypoxia-induced encephalopathy, neonatal sepsis, and respiratory distress. Prompt diagnosis and management can improve the perinatal outcomes.

Keywords: Aspiration, cesarean section, neonatal mortality, meconium-stained amniotic fluid, obstetrician