Study Of Meconium Stained Amniotic Fluid And Its Relation With Foetal Heart Rate And Mode Of Delivery

Abstract

Background: Obstetric teaching thought out this century has included the concept that meconium passage is a potential warning sign of foetal asphyxia. Whitridge J Williams, in 1903 observed the characteristic sign of impending asphyxia is escape of meconium. He attributed meconium passage to relaxation of sphincter muscle induced by faulty aeration of foetal blood. Though over time we have also realised that detection of meconium during labour is problematic in prediction of foetal distress or asyphyxia. Even though human labour is complicated by meconium, few of these are linked to infant mortality.

Methods: A clinical study of 70 cases of meconium stained amniotic fluid in cephalic presentation out of 200 deliveries. A careful clinical history was taken from all these cases particularly about age, parity, gravidity, previous obstetrics history and obstetric complications. Colour of amniotic fluid and type of meconium was noted at the time of amniotomy or spontaneous rupture of membrane and at the time of delivery and the eventual mode of delivery was recorded.

Conclusion: Meconium stained liquor is associated with increased rate of interventions, the decision regarding mode of delivery demands individual clinical judgement, weighing the estimated time until vaginal delivery against the estimated time until the onset of metabolic acidosis. Caesarean section rate in MSAF can be justified to ensure a better outcome for the neonate even in the presence of a normal CTG trace.