Study of early neonatal outcomes in babies delivered through meconium-stained amniotic fluid in a rural teaching hospital


  • Venkatesh Dhannaram Department of Pediatrics, Mediciti Institute of Medical Sciences, Medchal Mandal, Ghanpur, Telangana, India
  • Sumathi Kotapuri Department of Pediatrics, Mediciti Institute of Medical Sciences, Medchal Mandal, Ghanpur, Telangana, India
  • Sudharshanraj Chitgupikar Department of Pediatrics, Mediciti Institute of Medical Sciences, Medchal Mandal, Ghanpur, Telangana, India



MSAF, Early neonatal outcomes, Maternal risk factors


Background: When the fetus is in a state of stress meconium is passed presence of meconium in amniotic fluid is potentially a serious Sign of fatal compromise, frequency of meconium strained amniotic fluid ranges from 5-22%. MSAF results in higher rate of cesarean delivery, NICU admission rate, respiratory distress, PPHN and neonatal death. The primary objectives of the study were to estimate the incidence of Meconium aspiration syndrome & Respiratory distress among babies born through meconium-stained amniotic fluid (MSAF) along with studying the outcomes at the end of 7 days.

Methods: This was a prospective study undertaken in mediciti institute of medical sciences, Ghanpur Medchal Mandal from Jan 2018 to June 2019. Data was collected in a predetermined proforma after institutional ethical committee clearance and appropriate informed consent.

Results: During this period 1972 neonates were delivered of which 216 babies were born through MSAF. 18 were excluded for non-cephalic presentation, multiple gestation or congenital anomalies.198 babies were included in the study (96 male and 102 female). 18 neonates (10.2%) needed resuscitation at birth. 85 (42.9%) had thick MSAF. 43 of them developed respiratory distress (21.7%). 10 babies were ventilated. Seizures, hyperbilirubinemia, thrombocytopenia were more common among babies with thick MSAF. Mortality was 1%.

Conclusions: Thick meconium-stained amniotic fluid was associated with low Apgar score, higher rate of emergency cesarean section and meconium aspiration syndrome. Primigravida mothers, maternal hypothyroidism and oligohydramnios were important risk factors associated with MAS.

Author Biography

Sumathi Kotapuri, Department of Pediatrics, Mediciti Institute of Medical Sciences, Medchal Mandal, Ghanpur, Telangana, India

Assistant Professor, Department of Pediatrics


Jain PG, Sharma R, Bhargava M. Perinatal outcome of meconium stained liquor in pre-term, term and post-term pregnancy. Indian J Obstet Gynecol Res. 2017;4(2):146-50.

Rajput SS, Verma YS, Yadav D. Study of Risk Factors and Outcome in Neonates Born with Meconium-Stained Liquor. Scholars J Appl Med Sci. 2016;4(9E):3548-52.

Rajput U, Jain A. Impact of meconium-stained amniotic fluid on early neonatal outcome. J Evol Med Dental Sci. 2013;(2-45)11:8788-94.

Wiswell TE, Gannon CM, Jacab J. Delivery room management of the apparently vigorous meconium-stained neonate-Results of multicenter international collaborative trial. Paediatrics 2000;106:1-7.

Rathoria R, Rathoria E, Bansal U, Mishra M, Jalote I, Shukla NK et al. Study of rick factors and perinatal outcome in meconium-stained deliveries from a district of Uttar Pradesh, India. Int J Reprod Contracept Obstet Gynecol. 2018;7(9):3605-9.

Sankhyan N, Vijay K, Sarun R. Predictors of meconium-stained amniotic fluid: a possible strategy to reduce neonatal morbidity and mortality. J Obstet Gynecol India. 2006;56(6):514-7.

Harikumar S, Rajesh A. Study on Meconium-stained fluid-perinatal outcome. Int J Reprod Contracept Obstet Gynecol. 2018;7(2):587-95.

Keziah Joseph G, Kiran U, Reddy DR, Jain CS. Incidence of meconium aspiration syndrome and associated risk factors in babies born to mothers with meconium-stained amniotic fluid. Int J Contemp Med Res. 2017;4(7):1457-61.

Kamble MB, Jain P. Meconium aspiration syndrome: clinical profile, risk factors and outcome in central India. Int J Contem Pediatr. 2019;6(1):144-9.

Swain P, Thapalial A, Meconium-Stained Amniotic Fluid-A Potential Predictor of Meconium Aspiration Syndrome. J Nepal Paediatr Soc. 2008;28(1):3-6.

Rath SS, Mahapatra S, Behera N. Epidemiology and Associated Risk Factors of Meconium Aspiration Syndrome in A Tertiary Care Hospital, Odisha. Indian J Basic Appl Med Res. 2017:6(3):209-16.

Khazardoost S, Hantoushzadeh S, Khooshideh M, Borna S. Risk factors for meconium aspiration in meconium-stained amniotic fluid. J Obstetr Gynaecol. 2007;27:6:577-9.

Singh SN, Srivastava R, Singh A, Tahazzul M, Kumar M, Kanta C et al. Respiratory distress including meconium aspiration syndrome in vigorous babies born through meconium stained amniotic fluid: incidence, onset and severity of predictorsIndian J Pediatr. 2013;80(7):538-43.

Liu WF, Harrington T. Delivery Room Risk Factors for Meconium Aspiration Syndrome. Am J Perinatol. 2002;19(7):367-78.

Bezboruah G, Chakraborty A, Bhunia N. A Study of Clinico-Epidemiological Profile of Meconium Aspiration Syndrome in Newborn Admitted in NICU of Gauhati Medical College and Amp; Hospital. Sch J Appl Med Sci. 2016;4(10A):3553.

Coltart TM, Byrne DL, Bates SA. Meconium aspiration syndrome: a 6‐year retrospective study. BJOG: Int J Obstet Gynaecol. 1989;96(4):411-4.

Singh G, Singh O, Thapar K. Neonatal outcome in meconium-stained amniotic fluid: a hospital-based study. Int J Contem Pediatr. 2017;4(2):356-60.

Thomas C, Krishnan L. Necrotising enterocolitis. Indian paediatr. 1997;34.

Cheng S, Lu Q, Zhou M, Jialin YU. Taiwan Pediatric Association. J Pedneo. 2016;58:165-70.

Garg P, Barua D, Saxena S. Association of gestational age, Apgar score and neonatal outcomes in newborns with meconium-stained amniotic fluid. Int J Contem Pediatr. 2019;6(4):1563-6.

Rajlaxmi M, Manika A. Fetal Outcome in Meconium-Stained Deliveries. J Clin diagn Res. 2013;7(12):2874-6.

Ashtekar SD, Gaikwad RSNK. Clinical study of meconium aspiration syndrome in relation to birth weight and gestational maturity at general hospital Sangli. Int Med J. 2014;1(5):189-92.

Bhatia P, Ela N. Fetal and neonatal outcome of babies in meconium-stained amniotic fluid and meconium aspiration syndrome, J Obstet Gynecol India. 2007;57(6):501-4.

Fedakar A. Investigation of Meconium Aspiration Syndrome in Newborns, after NRP Protocol Changing. Eur Res J. 2019;5(5):776-80.

Firdaus U, Manazir Ali S, Sachdeva S. Maternal and neonatal factors associated with meconium-stained amniotic fluid. Curr Pediatr Res. 2013;17(1):37-40.






Original Research Articles