Meconium stained liquor and its neonatal outcome.

Nadia Mohammad,Taha Jamal,Arjumand Sohaila,Syed Rehan Ali

doi:10.12669/pjms.346.15349

Nadia Mohammad, Taha Jamal + Show 2 more

Open Access

https://doi.org/10.12669/pjms.346.15349

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Abstract

Objective:To determine the maternal factors and neonatal outcome of pregnancy complicated by meconium stained amniotic fluid.Methods:This one year retrospective study was conducted at the Agha Khan Hospital for Women-Garden Campus, it is a secondary care private teaching hospital. Demographics information included gestational age, gender and birth weight of baby, medical and obstetric complications during pregnancy, mode of delivery, neonatal outcome (Meconium Aspiration Syndrome (MAS) and need for admission in nursery) were recorded on a pre-designed proforma.Results:In our study the frequency of meconium stained amniotic fluid (MSAF) was 7.85%, out of them 12 % babies developed MAS. There was significant association between grades of meconium and MAS, babies with thick meconium were prone to develop MAS (P = 0.02). Emergency cesarean section was significantly associated with MAS. Gestational diabetes (GDM) and pregnancy induced hypertension (PIH) were the significant factors associated with MAS.Conclusion:Thick Meconium stained amniotic fluid was associated with low APGAR score, high rate of emergency cesarean section and meconium aspiration syndrome. Anemia during pregnancy, PIH and GDM were important risk factor associated with MAS.

Highlights

Meconium stained amniotic fluid (MSAF) is an alarming sign of fetal compromise and associated with a poor perinatal outcome
The mean birth weight of MSAF patients was 3.04 kg (± 0.38, range: 1.964.6), low birth weight (LBW) was seen in 6% of MSAF babies
Low APGAR score, Non-reassuring Cardiac tocography (CTG), meconium aspiration syndrome (MAS), and emergency Cesarean section were significantly associated with thick meconium stained liquor

Summary

Introduction

Meconium stained amniotic fluid (MSAF) is an alarming sign of fetal compromise and associated with a poor perinatal outcome. Incidence of meconium stained amniotic fluid ranges from 7-22%1 while meconium aspiration syndrome (MAS) occurs in approximately 5% of all cases of MSAF. MAS contributes to neonatal death in up to 0.05% (i.e. 1 in 2000 of all pregnancies).[2] Pakistan is number three among those ten countries who contribute two-thirds of the world’s neonatal deaths with an estimated neonatal mortality rate of 49 per 1000 live births.[3] One such attribute is MSAF, 27.3% of neonatal deaths had a history of or evidence of meconium passage during. Pak J Med Sci November - December 2018 Vol 34 No 6 www.pjms.com.pk 1392 delivery.[4] Passage of meconium is not common before 34 weeks of gestation, beyond that period the incidence gradually increases.[5]

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