Meconium Staining of Amniotic Fluid: A Clinical Study

Aims: To identify the frequency of meconium aspiration syndrome among the total births who suffered from meconium staining of amniotic fluid, to find out risk factors during pregnancy, therapies and various complications associated with this condition and their effects on perinatal outcome.
Study Design: Retrospective study.
Place and Duration of Study: AL-Yarmouk Teaching Hospital, between 1st of December 2009 to 31st of May 2010.
Methodology: Total number of live birth deliveries was 5965, live births with meconium staining of amniotic fluid were 286 and meconium aspiration syndrome cases were 13. Collection of information included gestational age, fetal presentation, mode of delivery, birth weight, sex, Apgar score, type of resuscitation, treatment, associated complications and outcome. Inclusion criteria for meconium staining of amniotic fluid cases were; gestational age of ≥30 wk, presence of meconium stained skin, umbilical cord or meconium in the trachea at birth.
Results: Total number of live birth deliveries matching criteria of inclusion in the study was 5965. Of these, 286 (4.8%) cases had meconium stained amniotic fluid which included 13 (4.5% of MASF cases, 0.21% or total live births) cases of meconium aspiration syndrome. Babies who were term or normal for gestational age were more prone to meconium aspiration syndrome and meconium stained amniotic fluid (P = .0008 and .016, respectively). Emergency cesarean section was significantly associated with a decreased rate of meconium stained amniotic fluid cases (P .0001). Thick meconium was more risky than thin (P = .0009).
Three neonates died due to meconium aspiration syndrome complicated by respiratory failure and pneumothorax. Mortality was 23.1% of total meconium aspiration syndrome cases and 1.04% of total meconium stain amniotic fluid cases.
Conclusion: Babies at highest risk of meconium aspiration syndrome and meconium stained amniotic fluid were those who had completed their term and who had an appropriate birth weight for their gestational age. Moreover, Thick meconium is associated with low Apgar scores and higher morbidity than thin meconium. Finally, abnormal presentation is an important risk factor for MAS, whereas emergency cesarean section is significantly associated with a decreased rate of meconium stained amniotic fluid cases.