Mekonyumlu Gebeliklerde Doğum Eyleminin ve Sonuçlarının Değerlendirilmesi: Prospektif Kohort Çalışması

Abstract

Background: The aim of this study was to determine the risk factors for meconium-stained amniotic fluid in a low-risk pregnancy and to evaluate birth complications and neonatal outcomes in deliveries with meconium-stained amniotic fluid (MSAF).
 Material and Methods: This prospective study was conducted between April 2015 and September 2015 at Ankara Zekai Tahir Burak Women’s Health Education and Research Hospital. 351 women with singleton pregnancies and cephalic position who had reached 37 weeks of gestation were included in the study. Women with known chronic systemic diseases, pregnancy complications, and previous uterine surgery were excluded. 151 cases with MSAF and 200 randomly selected control cases with clear amniotic fluid were included in this study. We compared the two groups in terms of maternal age, gravidity, parity, gestational age, intrapartum maternal fever, body mass index (BMI), duration of labor, cardiotocographic values (CTG), mode of delivery, neonatal outcomes, and admission to the neonatal intensive care unit.
 Results: In our study, meconium aspiration syndrome (MAS) developed in 2.6% (4/151) of neonates with meconium staining at birth. Gestational age, intrapartum maternal fever and BMI were significantly increased in the MSAF group (p=0.003). The duration of the active phase of labor (cervical dilation from 6 cm to 10 cm) was similar in both groups, and the duration of the second phase of labor was longer in the MSAF group (p=0.002). MSAF was associated with an increased number of abnormal results in cardiotocographic examinations, birth complications, and neonatal outcome (p < 0.001).
 Conclusion: Deliveries with meconium-stained amniotic fluid are associated with increased morbidity; therefore, intrapartum examinations should be performed more frequently and carefully, and precautions should be taken during labor in collaboration with pediatricians to reduce potential adverse neonatal outcomes.