Prevalence and Factors Associated with Meconium Staining of Amniotic Fluid, Meconium Aspiration Syndrome and Clear Liquor in South Indian New-born—Part II

Abstract

Meconium staining of amniotic fluid (MSAF) is a commonly observed phenomenon in day-today practice of obstetrics, advocates the quick delivery of baby as priority since majority 84% of newborns with MSAF were asphyxiated at birth OR 8.42 [CI95%] 5.1-14, P=0.0001 compared to those newborns with clear liquor. The prevalence of MSAF 7.8% however incidence of Me-conium Aspiration Syndrome (MAS) was 1.8%, but constituted 23% of MSAF parturient. Various high risk factors include primigravida, young mothers with obstetric complications of premature rupture of membranes (PROM) of more than one hour before labor occurred in 9.1% of 207MSAF pregnancies compared to only 7.3% in overall births. Similarly also Pregnancy induced hypertension (PIH) occurred in 9% with MSAF compared to an overall 5.6%. Gestational diabetes (GDM) was least 3.4% in MSAF pregnancies compared to overall 5.3%. While Grade II MSAF peaked in birth weight category 300-3499g category, most newborn of remaining parturient weighed between 2,500-2,999g. Peak births at 38 weeks comprised of newborns with clear liquor delivered normally, contrasted to peak births at 39 weeks for newborns with MSAF and MAS delivered mainly by emergency Lower Segment Caesarean Section (LSCS). Surprisingly commonest parturient blood group was AB+ve. In conclusion, effective preventive strategy would be early delivery by 38 weeks gestation preferably by elective LSCS, obviating in-tra-partum events in high risk cases, resulting in improvement of fetal and neonatal morbidity and mortality.