The effect of meconium on perinatal outcome: a prospective analysis.
OBJECTIVE
To evaluate the effect of meconium-stained amniotic fluid (AF) on perinatal outcome.


METHODS
A prospective observational study was performed, comparing perinatal outcome of parturients with thick and thin meconium-stained AF to those with clear AF.


RESULTS
The rate of meconium-stained AF was 18.1% (106/586). Of those, 78 (13.3%) patients had thin and 28 (4.8%) had thick meconium-stained AF. The rate of oligohydramnios was significantly higher among pregnancies complicated with thick meconium-stained AF (OR 7.2, 95% Cl 2.1-24.1; p = 0.002). A significant linear association, using the Mantel-Haenszel test for linearity, was found between the thickness of the meconium and abnormal fetal heart rate patterns during the first and second stages of labor, low Apgar scores at 1 min and the risk for Cesarean section. A statistically significantly higher risk for neonatal intensive care unit admission was observed among patients with thick meconium as compared to those with clear AF (OR 11.4, 95% CI 2.0-59.3; p = 0.006), even after adjustment for oligohydramnios and abnormal fetal heart rate patterns.


CONCLUSIONS
Thick, and not thin, meconium-stained AF, was associated with an increased risk for perinatal complications during labor and delivery. Therefore, thick meconium-stained AF should be considered a marker for possible fetal compromise, and lead to careful evaluation of fetal well-being.
Sheiner
E
E
Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben Gurion University of the Negev, Beer-Sheva, Israel. sheiner@bgumail.bgu.ac.il
Hadar
A
A
Shoham-Vardi
I
I
Hallak
M
M
Katz
M
M
Mazor
M
M
D000328:Adult; D000653:Amniotic Fluid / Q000502:physiology*; D005260:Female; D006340:Heart Rate, Fetal / Q000502:physiology; D006801:Humans; D016014:Linear Models; D008470:Meconium / Q000502:physiology*; D007744:Obstetric Labor Complications / Q000503:physiopathology; D016104:Oligohydramnios / Q000503:physiopathology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology; D011256:Pregnancy Outcome; D011446:Prospective Studies; D018570:Risk Assessment