Relationship between meconium staining and amniotic fluid volume in term pregnancies.
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.
Blackwell
Sean C
SC
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI, USA. sblackwel@med.wayne.edu
Wolfe
Honor M
HM
Redman
Mark E
ME
Hassan
Sonia S
SS
Berry
Stanley M
SM
Treadwell
Marjorie C
MC
Zador
Ivan
I
Carreno
Carlos A
CA
Sorokin
Yoram
Y
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