Abstract
Objective: The objective of the study was to determine the fetal outcome, magnitude of meconium stained amniotic fluid (MSAF) or meconium stained liquor (MSL), and risk factors responsible for MSAF at University Teaching Hospital in Lusaka, Zambia. That the frequency of MSAF during the period under study at UTH was 10.2%. It also demonstrated no significant difference in terms of good Foetal outcome at 5 minutes in women with MSAF compared with those without MSAF. (Adjusted p value= 0.773). Most women (90.2%) with MSAF also had good outcome of Apgar score 7 or more at 5 minute though less when compared to those without MSAF at 97.8%. Caesarean section (C/S) rate was high (37.6%)
 Methods: The study was a case control study conducted at University Teaching Hospital (UTH) in Lusaka Zambia from May to August 2018. Information was collected from a calculated sample size of 186 women using a structured interview schedule of which 93 were cases and another 93 were controls. Patient files were also used to collect data. In order to ensure that the findings were valid, the statistical significance was set at p < 0.05
 Results: The study found among women with MSAF versus 19.4 % among those without MSAF. There was also a strong association between MSAF and being delivered by C/S (Adjusted odds ratio = 4.579 and adjusted p value = 0.002) indicating that women with MSAF were 4.5 times more likely to be delivered by C/S as compared to those without MSAF. Electronic monitoring of patients with MSAF was low with only 33 (35.5%) of women with MSAF being monitored with cardiotocography (CTG). During the period under study, 30 (32%) women with MSAF had associated complications. However, there was no significant association between any demographic characteristic, and or investigated obstetric risk actor and MSAF
 Conclusion: The frequency of MSAF at UTH was 10.2%. The study demonstrated no significant difference in Foetal outcome at 5 minutes in women with MSAF compared with those without MSAF. However, Caesarean rate was noted to be high at 37.6% in those with MSAF compared to those without MSAF at 19.4%. No investigated complication was significantly associated MSAF at UTH.
Highlights
CHAPTER FOUR: RESULTSThe data and findings presented were obtained from 186 women participants fromUniversity Teaching Hospital (UTH) labour ward of which 93 had meconium stained liquor (MSL) and another 93 did not have
In India, Priyadharshini and Panicker (2012) found that meconium Stained liquor alone was not associated with an adverse neonatal outcome and that 86% of babies remained asymptomatic in spite of MSL and only required routine care
They found that oligohydramnios, pregnancy induced hypertension (PIH), anaemia and fetal distress were common antenatal and intranatal factors which were associated with meconium stained amniotic fluid (MSAF) and that major morbidity and indication for Neonatal Intensive Care Unit (NICU) admission was birth asphyxia and meconium aspiration syndrome
Summary
The detection of meconium stained liquor (MSL) during labour often causes anxiety in the delivery room because of its association with increased perinatal mortality and morbidity. Sheikh et al (2010) found that meconium stained liquor was associated with higher rate of Caesarean delivery, increased need for neonatal resuscitation and meconium aspiration syndrome. In India, Priyadharshini and Panicker (2012) found that meconium Stained liquor alone was not associated with an adverse neonatal outcome and that 86% of babies remained asymptomatic in spite of MSL and only required routine care. Ashfaq and Shah (2004) found that meconium by itself was not always associated with poor fetal outcome but that severe respiratory distress called meconium aspiration syndrome increased in cases of non-reassuring FHR. Studies of this nature had not been done previously in Zambia. The aim of this study was to determine the magnitude of MSL, fetal outcome and risk factors responsible for MSL at UTH
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