Immediate clinical outcome of newborns with meconium stained amniotic fluid

Raju V., Dhivya Narayani M., Vindyarani W. K.


Background: The detection of meconium-stained amniotic fluid during labour often causes anxiety in the delivery room because of its association with increased perinatal mortality and morbidity. The aim of the study is to determine whether meconium staining of amniotic fluid had an influence on the neonatal outcome and the factors responsible for meconium-stained amniotic fluid.

Methods: This case-control study was done between March 2015 to October 2017 in the Department of Paediatrics, Sri Muthukumaran Medical College, and RI. 217 newborns who had meconium staining of the amniotic fluid were taken into the study. For each case, two controls were taken. Mode of delivery of baby noted with the grading of meconium either thin or thick meconium. Type of resuscitation done for these babies was noted. Those newborns who were admitted in the newborn unit were followed up till discharge and type of management of these babies were monitored. The outcome of seizures, air leak, MAS etc., were looked for. For each MSAF baby, two newborns without MSAF were recruited and looked for maternal and fetal risk factors.

Results: Incidence of MSAF is 16.9%. Among 217 cases of MSAF, thin meconium constituted 141 cases (64.97%) and thick meconium 76 cases (35.02%). The incidence of thin meconium is more when compared to thick meconium. Of the 217 cases of meconium-stained liquor, 170 (78.7%) cases are vigorous babies and 47 (21.6%) are non-vigorous. Out of 47 babies who were non-vigorous, most of them (70.2%) had thick meconium stained liquor. Most of them, 172 cases (79.2%) required only routine resuscitation, whereas BMV with tracheal toileting required in 18 cases (78.3%) of thick MSAF when compared to 5 cases (21.7%) of thin MSAF.

Conclusions: MSAF is associated with morbidity and mortality when associated with factors like maternal PIH, anemia, oligohydramnios, IUGR babies and CTG showing FHR variability. The majority of which are thick meconium suggesting that consistency of meconium had a direct bearing on the neonatal outcome.



Ballord’s score, Cardiopulmonary resuscitation, Downe’s score, Meconium-stained amniotic fluid

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