What is the amniotomy effect on non stress test in patients meconium stained amniotic fluid?
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Objective: Meconium stained amniotic fluid is a frequently encountered situation, it can really disturb an obstetrician, as it increases the rates of neonatal morbidity and mortality and it is difficult to prevent meconium passage in utero. Noninvasive tests are needed to predict the meconium staining of the amnion fluid without making amniotomy or making a fetal invasive procedure. Non stress test is a commonly used method to determine the status of intrapartum fetal wellbeing. The purpose of this study was to predict fetal meconium release during labor by examining the fetal heart rate traces without performing an amniotomy procedure.
Materials and Methods: A total of 280 patients who have been diagnosed with active labor were included in the study. 140 of them demonstrated meconium stained fluid and 140 of them clear amniotic fluid. The patients’ labor courses have been watched and non-stress test results have been recorded besides obstetric outcomes.
Results: Non-stress tests performed before amniotomy; 52 (37.1%) of the non-stress tests in the meconium group were non-reactivated, whereas in the control group this count was 19 (13.5%) before amniotomy. When we accepted the deceleration entity as fetal distress; fetal distress was seen in 62(44.3%) of the patients in the meconium group and in 21(15.1%) of the patients in the control group.
Conclusion: In the presence of non-reactive non stress test pattern; we should be suspicious of meconium-stained amniotic fluid. In this case, caution should be taken in terms of fetal distress.
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