Details
Category: Volume 06 Issue 06 June 2018
Hits: 1213

Title: Meconium Stained Liquor, An Obstetrician’s Dilemma- A Clinical Study of Fetomaternal Outcome

Authors: Dr Prachi Singh, Dr Sachin Singh Yadav, Dr Prashant Dubey, Dr Shweta Yadav

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i6.174

Abstract

Introduction: Meconium stained amniotic fluid (MASF) is seen in 10-15% of all pregnancies. It is associated with maturation of the fetal Gastrointestinal Tract (GIT) but may also be associated with adverse neonatal outcome.

Objectives: The present study aims at studying the fetomaternal outcome in cases with meconium stained amniotic fluid.

Material and Methods: The present study was conducted in Rejshree Medical Research Institute Bareilly. Total 50 cases with MSAF fulfilling the inclusion criteria were included in the study. Various parameters were studied to know the fetomaternal outcome.

Result: In the present study the incidence of MSAF was 10.8%, thin MSAF was seen in 74% cases and thick MSAF in remaining 26%.MSAF was seen more commonly in primigravidas and with increase in gestational age. The incidence of abnormal FHR pattern was common in the thick meconium group (69.2%) as compared to thin meconium group(18.9%). The commonest mode of delivery in cases with thin MSAF was normal vaginal delivery (51.5%) while in cases with thick MSAF was by lower segment caesarean section (LSCS) (61.5%). The incidence of NICU admission in thin MSAF group was 18.9% while in thick MSAF 46.1% required NICU admission.

Conclusion: Since the incidence of perinatal morbidity and mortality is more in cases with meconium stained amniotic fluid, so the cases with meconium staining of amniotic fluid should be monitored more vigorously with timely interventions and proper neonatal resuscitation. 

Keywords: MSAF-Meconium stained amniotic fluid, LSCS., fetal Gastrointestinal Tract (GIT).

References

  1. Wiswell TE, TuggleJM, TurnerBS. Meconium aspiration syndrome: Have we made a difference? Pediatrics1990;85:715-21
  2. Woods JR, GlantzJC.Significance of amniotic fluid meconium. In Creasy RK ReskinR, Editors. Maternal fetalmedicine: Principles and Practice. Philadelphia WB: Saunders:1994;413-422
  3. Mundhra R, Agarwal M. Fetal Outcome in Meconium Stained Deliveries. Journal of Clinical and Diagnostic Research : JCDR. 2013;7(12):2874-2876.
  4. Krebs HB, Petres HE Dunn CJ, Jordann HVF Segreti A. Intrapartum fetal heart monitoring. Am J Obstet, Gynecol 1980;137:936-942
  5. Mazor M, Furman B, Wiznitzer A, Shoham- Vardi I, Cohen J, Ghezzi F. Maternal and perinatal outcome of patients with preterm labour and meconium stained amniotic fluid. Obstetrics & Gynecology 1998;86:830-3.
  6. Nathan L, Leveno KJ, Carmody TJ, Kelly MA, Sherman ML. Meconium: A 1990s perspective on an old obstetric hazard. Obstet Gynecol 1994;83:329-332.
  7. Ramin K, Leveno K, Kelly M. Observations concerning the pathophysiology of Meconium Aspiration Syndrome. Am J Obstet Gynecol 1994: 170;312(#124).
  8. Starks C Gregory. Correlation of meconium stained amniotic fluid, early intrapartum fetal pH and Apgar scores as predictors of perinatal outcome. Obstet and Gynecol, 1980;56(5):604-9.
  9. Low JA, Pancham SR, Worthington O, Bolton RW. The incidence of fetal asphyxia in 600 high risk monitored pregnancies. Am J ObstetGynecol 1975;121:456-59.
  10. Meis PJ, Hall M, Marshall JR, Hobel CJ. Meconiumpassage: a new classification for risk assessment during labour. Am J ObstetGynecol1978;131:509-13.
  11. Cunningham FG, Gant FN, Leveno KJ, Giltrap LL, Haulth CJ, Wentron DK, Williams Obstetrics 21st ed, Mc Graw Hill;2001.
  12. Ahanya SN, Laksnanan J, Morgan BL, Ross MG. Meconium passage in utero: mechanism, consequences and managem-ent. Obstet GynecolSurv 2004;60:45-56.
  13. Nirmala Dhuhan et al.Meconium staining of amniotic fluid, a poor predictor of fetal response .J K Science vol 12 no. 4 Oct-Dec 2010.
  14. Hari Bhaskar S,Kartikeyen G, Vishnu Dut B, Bhatiya BD.Antenatal risk factors and neonatal outcome in meconium aspiration syndrome. Indian J. Maternal and Child Health 1997:8(1);9-12.
  15. Rev Sauda et al. MSAF and maternal and neonatal factors associated. Rev saudepublica; 2012 Dec (46) 1023- 9 and publ 2013.
  16. Becker S, Solomayer E, Dogan C, Walweiner D, Fehm T, meconium stained amniotic fluid- perinatal outcome and obstetrical management in rural and suburban population. Eur J Obstet Gynecol Reprod Biol.2007 May;132(1):46-50.
  17. Fischer C, Rybakowski C, Ferdynus C, Sagot P, Gouyon GB. A population based study of MAS in neonates born between 37- 43 weeks of gestation.Int J Paediatrics 2012, & pages doi:10.1155/2012/32154.
  18. Kumari S,Gupta SN, Mahato IP, Giri R, Yadav A, Thakur A. Health renaissance September to December, 2012;10(3):198-202
  19. Odogo BE, Ndavi PM, Gachuno OW, Sequira E. Cardiotocography and perinatal outcome in pregnant women of 37-42 weeks gestation. Pak J Surg.2010:27 (4):292-8.
  20. Naqui SB, Manzoor S.Association of meconium stained amniotic fluid with perinatal outcome with perinatal outcome in pregnant women of 37-42 weeks gestation. Pak J Surg 2011;27(4):292-298.
  21. Wong WS, Wong KS, Chang A. Epidemology of meconium staining of amniotic fluid in Hong Kong.Aust N Z J Obstet Gynaecol.1985 May;25(2):90-3
  22. Patil KP, Swamy MK,Samantha K.A one year cross sectional study of management practices of meconium stained amniotic fluid and perinatal outcome. J Obstet Gynecol India, 2006;56(2):128-30.

Corresponding Author

Dr Sachin Singh Yadav

Associate Professor, Department of Community Medicine, Teerthanker Mahaveer Medical College, Moradabad (UP)

101, Old Faculty Block, Teerthanker Mahaveer University, Moradabad (UP), India

Mobile: - 8059491821, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.