The relative risk of 'fetal distress' in pregnancy associated with meconium-stained liquor at different gestation

Abstract

Pregnancies complicated with meconium-stained liquor are regarded as at risk of fetal distress. Evidence from animal and human studies indicate that passage of meconium may be related to fetal maturity. This retrospective study attempts to quantify the relative risk of non-reassuring cardiotocography or 'fetal distress' in pregnant women complicated by meconium-stained liquor for preterm, term and post-term pregnancies. A total of 9542 singleton pregnancies, delivered in a tertiary obstetric unit in Hong Kong between 1 July 1996 and 31 June 1999, were included in the study. Of these pregnancies, 1946 (20·4%) were identified as having meconium-stained liquor, ranging from thin to thick staining. There was a strong association between incidence of meconium-stained liquor ( P < 0·0005) and moderate/thick meconium-stained liquor with advanced gestational age. The incidence of non-reassuring cardiotocography in women presenting with meconiun-stained liquor was significantly higher (9·8% vs. 6·4%). The relative risk of non-reassuring cardiotocography in women with meconium-stained liquor increased with more advanced gestation. Close fetal surveillance during labour is required among these pregnancies. Premature labour is associated with higher incidence of fetal distress but the presence of meconium did not pose an additional risk.