Abstract

Introduction

• Meconium stained amniotic fluid has long been implicated as a factor influencing fetal well being during intra-partum and post-partum periods. Obstetric Management is significantly effected by presence of Meconium Stained Amniotic Fluid (MSAF) possibility reflecting low threshold for obstetric intervention.
• Meconium-stained amniotic fluid, as a result of the passage of fetal colonic contents into the amniotic cavity, is noted in approximately 12% of all deliveries.
• Meconium aspiration syndrome (MAS) is noted in 5% of these infants and more than 4% of MAS infants die, accounting for 2% of all perinatal deaths.

There is strong evidence most meconium passage occurs by each of three basic mechanisms:

1. As a physiologic maturational event.
2. As a response to acute hypoxic events occurring late in pregnancy.
3. As a response to chronic intrauterine hypoxia.

Many maternal factors contribute to passage of meconium before birth which include maternal age, prolonged gestation, type of labour, anemia, hypertension and toxemia of pregnancy^[1.2]. Type of meconium passage and time of passage are significant factors affecting fetal outcome.