A study of factors causing meconium stained amniotic fluid and it’s impact on perinatal outcome

Abstract

Objectives: To identify the risk factors for meconium stained amniotic fluid (MSAF) and it’s impact on perinatal outcome. Materials and Methods: This prospective, observational study was conducted in labour room & operation theatre of St. Theresa’s Hospital from May 2015-May 2016. A total of 110 women who were found to have meconium on spontaneous or artificial rupture of membranes were monitored with fetal heart rate abnormalities,5 minute APGAR score and neonatal complications like meconium aspiration syndrome(MAS) as outcome variables. Results: The results of the study were analysed statistically using Windostat Version 9.2. The incidence of MSAF was 12.01%. Based on this study, it is evident that the incidence of MSAF was more in women with Oligohydramnios , Prolonged pregnancy , Diabetes complicating pregnancy , Hypertensive disorders in pregnancy, Fetal growth restriction and in women with induced labour. The Chi Square test was applied between Grades of Meconium and APGAR Score. p value< 0.05 which was statistically significant. Also, the study between Grades of Meconium and Cardiotocograph (CTG) pattern proved to be significant with p value < 0.05. Conclusion: MSAF alone is not associated with an adverse neonatal outcome, 78.18% of abies remained asymptomatic. Increasing grade of meconium is associated with increased adverse outcome. Association of MSAF with abnormal CTG is associated with poor outcome, increased caesarean section rate, increased neonatal complications. The presence of thick meconium is associated with increase in the perinatal morbidity and mortality and hence its presence should not be overlooked. Keywords: MSAF, CTG, APGAR score, Meconium Aspiration Syndrome.