Meconium-stained amniotic fluid--perinatal outcome and obstetrical management in a low-risk suburban population.
OBJECTIVE
To determine whether amniotic fluid (MSAF) affects obstetrical interventions and immediate perinatal outcome in a low-risk suburban population.


METHODS
A retrospective cohort study examined 11,226 deliveries at Tübingen University Hospital (1998-2003). Thousand one hundred and twenty-three women (10%) had MSAF during labor. A control group of matched pairs was created, assigning to each patient the next woman that gave birth without MSAF. Exclusion criteria were: gestational age less than 37+0 weeks, primary Cesarean (C-)section, multiple gestation, severe maternal disease, preeclampsia and fetal malformations.


RESULTS
Only small differences were noted between the meconium and non-meconium groups with regard to arterial pH and Apgar scores: mean arterial-pH was 7.26 (+/-0.7) for both. Five minutes Apgar scores <6 occurred in 0.9% versus 0.4%. Obstetrical interventions were more common in the meconium group: C-section rates were 17.4% versus 9.6%, vaginal operative delivery rates 13.9% versus 6.2% and scalp pH rates 9.5% versus 3.7%, respectively.


CONCLUSIONS
In a low-risk suburban population the effect of MSAF on the newborn during the immediate postpartum period was small. However, obstetrical management was significantly effected by the presence of MSAF, possibly reflecting a combination of more difficult labor and a lower threshold for obstetric intervention.
Becker
Sven
S
Universitätsfrauenklinik Tübingen, Tübingen University Medical Center, Calwerstrasse 7, 72076 Tübingen, Germany. sven.becker@med.uni-tuebingen.de
Solomayer
Erich
E
Dogan
Cemal
C
Wallwiener
Diethelm
D
Fehm
Tanja
T
D000328:Adult; D000653:Amniotic Fluid; D001034:Apgar Score; D015331:Cohort Studies; D005260:Female; D005323:Fetal Monitoring / Q000379:methods; D006801:Humans; D008423:Maternal Age; D008470:Meconium; D007744:Obstetric Labor Complications / Q000473:pathology*; D010298:Parity; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D013383:Suburban Population