title: Relationship between meconium staining and amniotic fluid volume in term pregnancies.
abstract: OBJECTIVE
  Our purpose was to evaluate the relationship between meconium-stained amniotic fluid (MEC-AF) and amniotic fluid volume (AFV) and their impact on the risk of cesarean delivery for fetal indications in term pregnancies.
  
  
  METHODS
  1,655 live-born singleton gestations delivering at > or = 37 weeks within 7 days of sonographic assessment of the amniotic fluid index (AFI) were studied. AFI was categorized as: oligohydramnios (< or = 5.0 cm); decreased (5.1-8.0 cm); normal (8.1-18.0 cm); increased (18.1-23.9 cm), and polyhydramnios (> or = 24.0 cm). Frequencies of MEC-AF for each AFV category were stratified by gestational age (GA) and rates of cesarean delivery for fetal indications compared between patients with clear amniotic fluid and those with MEC-AF. Stepwise logistic regression analyses were performed for determinants of MEC-AF and the need for cesarean delivery for fetal indications.
  
  
  RESULTS
  The frequency of MEC-AF at birth in term pregnancies was not related to AFV: oligohydramnios (16.7%); decreased (16.7%); normal (20.1%); increased (24.4%), and polyhydramnios (22.1%). The only factor associated with the occurrence of MEC-AF was increasing GA at delivery (p < 0.01). Both MEC-AF (p < 0.02) and decreasing neonatal ponderal index (p < 0.02) were independently associated with cesarean delivery for fetal distress.
  
  
  CONCLUSIONS
  MEC-AF does not appear to be related to AFV in term pregnancies, and its presence increases the risk of cesarean delivery for fetal distress independent of AFV and neonatal ponderal index.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI, USA. sblackwel@med.wayne.edu
authors.forename: Sean C
authors.initials: SC
authors.lastname: Blackwell
authors.forename: Honor M
authors.initials: HM
authors.lastname: Wolfe
authors.forename: Mark E
authors.initials: ME
authors.lastname: Redman
authors.forename: Sonia S
authors.initials: SS
authors.lastname: Hassan
authors.forename: Stanley M
authors.initials: SM
authors.lastname: Berry
authors.forename: Marjorie C
authors.initials: MC
authors.lastname: Treadwell
authors.forename: Ivan
authors.initials: I
authors.lastname: Zador
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Carreno
authors.forename: Yoram
authors.initials: Y
authors.lastname: Sorokin
mesh_terms: D000653:Amniotic Fluid; D002585:Cesarean Section; D005260:Female; D005865:Gestational Age; D006801:Humans; D016015:Logistic Models; D008470:Meconium; D016104:Oligohydramnios / Q000000981:diagnostic imaging; D006831:Polyhydramnios / Q000000981:diagnostic imaging; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D016216:Ultrasonography, Prenatal