Main Article Content
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.
2. Karatekin G, Kesim MD, Nuhoglu A. 1999. Risk factor for meconium aspiration syndrome. International Journal of Gynecology and Obstetrics 65:295 – 297.
3. Ahanya SN, Lakshmanan J, Morgan BL, Ross MG. Meconium passage in utero: mechanisms, consequences, and management. Obstet Gynecol Surv 2004; 60: 45-56
4. Cleary GM, Wiswell TE. Meconium-stained amniotic fluid and the meconium aspiration syndrome. An update. Pediatr Clin North Am 1998;45:511–529.
5. Ashfaq F, Shah AA, Effect of aminoinfusion for meconium stained amniotic fluid on perinatal outcome. J Pak Med Assoc 2004; 54: 322-5.
6. Shaikh EM, Mehmood S, Shaikh MJ. Neonatal outcome in meconium stained amniotic fluid- One year experience. J Pak Med Assoc. 2010;60(9):711-14.
7. Balchin I, Whittaker JC, Lamont RF, Steer PJ. Maternal and fetal characteristics associated with meconium-stained amniotic fluid. Obstet Gynecol 2011;117:828-35
8. Khazardoost S, Hantoushzadeh S, Khooshideh M, Borna S. Risk factors for meconium aspiration in meconium stained amniotic fluid. J Obstet Gynaecol 2007; 27(6):577-9.
9. Xu H, Wei S, Fraser WD. Obstetric approaches to the prevention of meconium aspiration syndrome. J Perinatol 2008;28 Suppl 3:S14-8.
10. Mundhra R, Agarwal M. Fetal outcome in meconium-stained deliveries. J Clin Diagn Res 2013; 7: 2874-2876.
11. Sunoo C, Kosasa TS, Hale RW. Meconium aspiration syndrome without evidence of fetal distress in early labor before elective cesarean delivery. Obstet Gynecol 1989;73:7079.
12. Wong SF, Chow KM, Ho LC. The relative risk of 'foetal distress' in pregnancy associated with meconium-stained liquor at different gestation. J Obstet Gynaecol 2002; 22: 594-9.
13. Paz Y, Solt I Zimmer EZ. Variables associated with meconium aspiration syndrome in labour with thick meconium. Eur J Obstet Gynaecol Reprod Biol 2001; 94: 27-30.
14. Becker S, Solomayer E, Dogan C, Wallwiener D, Fehm T. Meconium-stained amniotic fluid-perinatal outcome and obstetrical management in a low-risk suburban population. Eur J Obstet Gynecol Reprod Biol 2007; 132: 46-50.
15. Barbosa da Silva FM, Koiffman MD, Osava RH, Junqueira SMVO, Gonzalez Riesco ML. Centro de Parto Normal como estratégia de incentivo del parto normal: estudo descriptivo. Enferm Glob. 2008;(14):1-13
16. Karim R, Jabeen S, Pervaiz F, Wahab S, Yasmeen S, Raees M. Decreased amniotic fluid index and adverse foetal out come at term. J Postgrad Med Institute 2010; 24: 307-11.