Abstract
The presence of meconium stained amniotic fluid (MSAF) is a sign of fetal compromise. It is associated with significant neonatal morbidity and mortality. MSAF is frequently associated with high cesarean rate, prolonged labour,low APGAR scores, increased rate of birth asphyxia; increased NICU admission, meconium aspiration syndrome and neonatal death. The aim of this prospective study is to correlate the effect of meconium stained amniotic fluid on neonatal outcome.
 Keywords: Meconium stained amniotic fluid, Neonatal morbidity and mortality, NICU.
Highlights
The fetus and the newborn cannot be considered as two distinct entities
meconium stained amniotic fluid (MSAF) is frequently associated with high cesarean rate, prolonged labour,low APGAR scores, increased rate of birth asphyxia; increased NICU admission, meconium aspiration syndrome and neonatal death
MAS is more frequently seen in post-term pregnancy. Factors such as placental insufficiency, maternal hypertension, pre-eclampsia, oligo-hydroamnios result in, in utero passage of meconium[7].The moderate and thick meconium group has a significantly greater risk of an abnormal fetal heart rate, low 1 and 5 minute Apgar scores, a cord blood pH of less than 7.2,birth asphyxia, need for O2 support and NICU admission of babies[5].Aspiration of the meconium into fetal or neonatal lungs is associated with clinical disease ranging from mild respiratory distress to severe respiratory compromise and causes significant increase in perinatal morbidity and mortality[8].Early identification of high risk cases with improved neonatal and perinatal care can decrease perinatal mortality[9]
Summary
Any situation that compromises the fetus’ well-being e.g alterations in the amniotic fluid quantities and properties, could influence the clinical status of the neonate at birth, and in severe cases, compromise its future.[1] Meconium is found in fetal gut from 10 weeks of gestation but passage of meconium in amniotic fluid is rare before 34 weeks. Passage of meconium into amniotic fluid might be a physiologic phenomenon of GIT maturation, or as a sign of acute or chronic hypoxic event, making it a indicator of fetal distress[4]. Meconium has been viewed as a harbinger of impending or ongoing fetal compromise and is associated with fetal hypoxia, acidosis or fetal distress[5].The predictive value of meconium was better when it occurred in high risk patients and was thick, dark and tenacious. Stained meconium had a poor correlation with fetal hypoxia[6]
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