Abstract
Objective
To determine the intrapartum and perinatal results associated with different degrees
of staining of meconium stained amniotic fluid (MSAF).
Study design
In a retrospective cohort study of all singleton deliveries over a period of one year
(2015) in a tertiary hospital, we compared different degrees of MSAF (yellow, green
and thick) to clear amniotic fluids, and analysed in each group maternal, intrapartum
and neonatal variables as well as umbilical cord blood gas analysis.
Results
Of the 3590 deliveries included, 503 (14%) had MSAF. The incidence of MSAF rises with
gestational age at delivery, reaching 20.7% in gestations above 41 weeks compared
to 4.3% below 37 weeks. As the amniotic fluid staining progresses we found a higher
proportion of intrapartum fevers (p < 0.001), pathological fetal heart rate patterns
(p < 0.05), operative vaginal deliveries and cesarean sections (p < 0.001), as well
as the need for advanced neonatal resuscitation (p < 0.001). There was also a correlation
between MSAF and low Apgar scores at five minutes (p < 0.001) and fetal-neonatal mortality
(p < 0.001) but there was not a higher proportion of neonatal intensive care admissions
(p > 0.05). We have observed a similar distribution of umbilical artery pH ranges
in all groups (p > 0.05).
Conclusions
MSAF was associated with an increase in the rate of pathological fetal heart rate
patterns, intrapartum fevers, operative vaginal and cesarean section deliveries, need
for neonatal resuscitation, low Apgar scores and higher fetal-neonatal mortality.
Moreover, we found that the risks increase as the staining and consistency of the
amniotic fluid evolves so it should alert the obstetrician and paediatrician to the
potential adverse outcomes.
Keywords
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Article info
Publication history
Published online: March 20, 2018
Accepted:
March 19,
2018
Received:
February 17,
2018
Identification
Copyright
© 2018 Published by Elsevier B.V.
