Meconium stained amniotic fluid in very low risk pregnancies at term gestation.
OBJECTIVE
To determine the prevalence and clinical significance of meconium stained amniotic fluid (MSAF) in a low risk population at term gestation and to investigate whether MSAF is a predictor for intrapartum and neonatal morbidity.


METHODS
A very low risk population including 37 085 consecutive deliveries at term composed the study population. A cross-sectional study was conducted and two groups of patients were identified according to the presence (n=6164) or absence (n=30921) of meconium in the amniotic fluid at delivery and the outcomes of the two groups compared.


RESULTS
The prevalence of MSAF was 16.6%. The incidence of cesarean section (5.6% vs 2.3% P<0.01), instrumental deliveries (3.2% vs 1.8% P<0.01), fetal distress (6.5% vs. 2.1% P<0.01), clinical chorioamnionitis (0.2% vs. 0.1% P<0.01), post-partum infection (0.5% vs. 0.2% P<0.01), 1-minute Apgar score <3 (1.9% vs. 1.1% P<0.01), small for gestational age (7.4% vs. 6.4% P<0.01). was significantly higher in the MSAF compared with the clear amniotic fluid group. Intrapartum and neonatal mortality in this low risk population was significantly higher in the MSAF group (1.7/1000) compared with women with clear AF (0.3/1000).


CONCLUSIONS
MSAF in a low risk population at term gestation is a predictor for adverse perinatal outcome and peripartum complications.
Maymon
E
E
Department of Obstetrics and Gynecology, Soroka Medical Center, Faculty of Health Sciences Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Chaim
W
W
Furman
B
B
Ghezzi
F
F
Shoham Vardi
I
I
Mazor
M
M
D000653:Amniotic Fluid; D001034:Apgar Score; D002585:Cesarean Section; D002821:Chorioamnionitis / Q000453:epidemiology; D036861:Delivery, Obstetric; D005260:Female; D005316:Fetal Distress / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D007239:Infections / Q000453:epidemiology; D008470:Meconium; D011247:Pregnancy; D011256:Pregnancy Outcome; D011644:Puerperal Disorders / Q000453:epidemiology; D012307:Risk Factors