THE SIGNIFICANCE OF MECONIUM STAINED AMNIOTIC FLUID – A CROSS SECTIONAL STUDY IN A RURAL SETUP

Background: The significance of meconium in amniotic fluid is a widely debated subject. Traditionally meconium has been viewed as a harbinger of impending or ongoing fetal compromise; however some investigators believe that it is not associated with fetal hypoxia, acidosis or fetal distress. Others have found lower Apgar scores in meconium stained neonates. Objectives: To study the correlation of meconium in amniotic fluid with perinatal outcome. Methods: 120 consecutive, term, labouring women with meconium stained amniotic fluid on spontaneous/artificial rupture of membranes were monitored during labour with fetal heart rate abnormalities, one and five minute apgar score , umbilical  cord pH at birth and neonatal complications, as outcome variables. Results:. Fetal heart rate variations were more often in cases with thick meconium (86.36%) than with thin meconium (9.75%%) (p value < 0.005). Thick meconium group neonates had lower Apgar scores as compared to moderate and thin meconium group. The umbilical cord blood pH was below 7.2 in 4(11.4%) neonates of thin meconium, 15(42.85%) in moderate meconium g and 30(68.18%) in thick meconium group (P value below 0.001). Neonatal complications were found in 36.36% of thick meconium group as compared to 14.28% of moderate meconium and none in thin meconium. Conclusions: Thick meconium should suggest immediate intervention, need for skilled paediatrician at the time of delivery and intensive care in the neonatal period to give a positive outcome

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