Fetal Outcome in Deliveries with Meconium Stained Liquor

Abstract

Introduction: Meconium staining amniotic fluid is associated with lots of adverseoutcome and has long been considered to be a bad predictor of fetal outcome.Objective: This prospective observational study was undertaken to find out immediatefetal outcome in meconium stained liquor.Materials and Methods: This study was conducted in Obstetrics and Gynecologydepartment of Dhaka National Medical Collage Hospital from July to December 2008.The pregnant women with yellow, brown and thinly stained amniotic fluid in labour withgestational age 37 completed weeks were enrolled in the study. Their babies weretaken as case and followed upto 7 days after delivery in National Medical CollageHospital and in Dhaka Shishu Hospital after admission when required. Babies bornwithout meconium stained liquor were taken as a control.Results: Total 80 cases were enrolled in the study as case and 80 cases wereenrolled as control. Mean gestational age was 39.3±1.5 weeks in cases and 38.5±1.3weeks in control. There was 13.8% pregnancy induced hypertension in case groupand 3.8% in control group. Pre-eclampsia were present 10% in case group and 1.1%in control group (p<0.05). Caesarean deliveries were high (75%) in cases and it wasmuch higher with thick meconium (75%) as compared to the thin meconium (25%,p<0.001). Apgar scores in first minute and fifth minute were also low in cases. Birthasphyxia was more in cases (20%). Meconium Aspiration syndrome (25%) andConvulsion (3.8%) were developed only in cases. Admission in neonatal ward wasmore (22.5%) in cases (p<0.05) as compared to control. Neonatal mortality was high(3.8%) in cases than control (1.3%).Conclusion: Meconium stained amniotic fluid were associated with higher rate ofcaesarian delivery, increased need for neonatal resuscitation, increased rate of birthasphyxia with hypoxic ischemic encephalopathy, meconium aspiration syndrome,hospital admission and mortality.Key words: Meconium stained liquor; foetal outcome.DOI: 10.3329/bjch.v33i2.5675Bangladesh Journal of Child Health 2009; Vol.33(2): 41-45

Perinatal and neonatal outcome in meconium stained amniotic fluid

“…Similar results were found in a study by Swain et al 6 In our study mean gestational age of cases was higher than controls (p=0.16). Mean gestational age of cases and controls is 39.73+/-1.2 weeks and 39.18+/-2.8 weeks respectively similar to findings of Khatun et al, Rosario et al, Mundhra et al [7][8][9] Fetal CTG abnormalities were more common in cases and were noted in 29.6% cases compared to 9.3% of controls in our study (p=<0.001). Our findings were consistent with findings of Gupta et al, Mundhra et al, Odongo.…”

“…In study by Gupta et al, Swain et al noted HIE in 6.66% of the cases similar to findings of Khatun et al 6,7,10 Comparing the mortality of the babies in cases and controls in our study, it was higher in the cases being 7.4% against 2.03% in controls. In the thick meconium subgroup, it was much higher whereas neonatal mortality of thin meconium subgroup (2.63%) and controls (2.03%) was similar to, Khatun et al, Gupta et al 7,10 …”

“…The reason for higher incidence of LSCS in our study among the cases was because of associated abnormal CTG findings especially in patients with thick meconium. Similar results were noted by Gupta et al, Naqvi et al, Khatun et al, Wong SF et al, Mundhra et al 7,9,10,12,13 Apgar score was noted in all the babies at 1 minute and 5 minutes and resuscitation was done in non-vigorous babies with low APGAR score. One baby in each group had APGAR score of 0 at birth and after resuscitation in our study.…”

“…Swain et al in their study performed oropharangeal suction in all cases,similar to findings of Khatun et al, Mundhra et al In a study by Odongo et al there was no significant difference in the mean 24.5% of the cases were admitted in NICU whereas 75.5% of the cases did not require NICU admission in our study. 6,7,9,11 Among controls only 5.7% needed NICU admission and 94.3% were asymptomatic at birth (p=< 0.001). In a study by Mundhra et al 80% of babies among cases were asymptomatic at birth as compared to 93.16% babies in the controls group (p=<0.0001).…”

Maternal and fetal out come in meconium stained amniotic fluid in a tertiary centre

“…Requirement of oropharyngeal suction was more in MSAF. 22 Meconium aspiration syndrome developed in 34.7% among them it was higher in thick meconium. Admission to NICU was more in cases & neonatal mortality was also higher in cases than controls.…”