Neonatal Outcome in cases of Meconium stained Amniotic Fluid

BACKGROUND: To determine the neonatal outcome in patients with meconium stained liquor during labour. MATERIALS AND METHODS: It is a prospective study which was conducted over period of 1 year from July 2008 to June 2009 at Shri Sayaji General Hospital. 271 cases of meconium stained amniotic fluid were enrolled in the study at random keeping following selection criteria; Full Term Live Pregnancy, Singleton Pregnancy, Vertex Presentation, MSAF (Meconium Staining of Amniotic Fluid) after rupture of membrane. Selection criteria for control cases are; Full Term Live Pregnancy, Singleton Pregnancy, Vertex Presentation, Clear Liquor Amni. RESULTS: Out of 271 cases 44 babies aspirated meconium and out of 44 (16.23%) babies 14 (5.16%) babies developed meconium aspiration syndrome. 11 out of 14 babies were detected thick meconium in early labour while 3 out of 14 babies were detected thick meconium in late labour. No baby with MAS was detected with thin meconium. All cases of MAS were associated with abnormal FHR. Total number of SBA babies according to 1 minute APGAR were decreased significantly in APGAR at 5 minutes. 79 cases from MSAF group showed absent normal weight gain pattern as compared to 14 cases from control group. Slightly more number of MSAF babies fell in category >3000 babyweight. 100% babies with MAS had respiratory distress with positive chest x-ray, 28.5% MAS babies developed sepsis, 21.48% develop seizure, 71.42% developed hyperbilirubinimia, 14.2% babies expired. CONCLUSION: Alone MSAF is not an indicator of fetal outcome.MSAF in absence of any abnormal heart rate pattern is not a sign of poor neonatal outcome. Overall neonatal morbidity and mortality is higher in MSAF group Because of increased NICU admissions, deprivation from breast milk and later on lack of bonding with mother and other morbidities, overall rate of weight gain is slow in MSAF group.