STUDY OF THE INCIDENCE AND EFFECT OF MECONIUM STAINED AMNIOTIC FLUID ON FETAL MORBIDITY AND MORTALITY OF NEONATES BORN

Abstract

Aims and objectives: Meconium stained amniotic fluid was considered a sign of fetal distress and associated with poor fetal outcome, but others considered physiological phenomena to be meconium passage through the fetus and create environmental threats to the fetus before birth. Such magnitude of different opinions was the object behind taking up this study and the aim was to find out the incidence and effect of meconium in terms of morbidity and mortality. Material and Methods: The present study was undertaken to evaluate the significance of MSAF and its fetal outcome in parturients admitted to a tertiary care hospital between June 2012 to June 2014. Detection of MSAF during delivery and follow-up of mother and baby during hospital stay was done. A total number of 100 cases were studied in each group as a prospective study. Results: The total numbers of deliveries during the study period were 850 of which 100 cases had meconium staining of AF (11.6%). Thin meconium staining was seen in 37 cases (4.35%) and Thick meconium was seen in 63 cases (7.41%). The major neonatal complication was birth asphyxia in MSG (19%) which was more in thick MSG (14%). Neonatal morbidity was more in the newborn with the thick meconium group (36.5%) compared to the thin meconium-stained group (29.7%). Early neonatal mortality was 100% associated with thick MSG. Early neonatal death was 2 in thick MSG and it was due to MAS. Stillbirth was 100% associated with thick MSG and it was 4. Whereas stillbirth in the control group was 1. Perinatal mortality was 6% in MSG that was associated with thick MSG. In the control group, it was 1%. Consistency of meconium has a direct bearing on the fetal outcome. In the thick meconium-stained group, Neonatal morbidity was (in our study group) 23 out of 63 cases. Stillbirth was 4; early neonatal death was 2 out of 63 cases. Whereas in thin MSG neonatal morbidity was 11 out of 37 cases. No stillbirth or neonatal death occurred in thin MSG. Conclusion: Immediate airway management, need for suction, and intubation should be guided by the state of the newborn rather than the presence of meconium. Timely diagnosis and management of amniotic fluid stained with meconium can enhance the fetal outcome. The authors of the current study conclude that MSAF adversely affects the fetal outcome mainly by thick meconium.