Perinatal Outcome in Cesarean and Vaginal Delivery in Meconium-stained Amniotic Fluid
DOI:
https://doi.org/10.56056/406Keywords:
Caesarean section, Fetal outcomes, Meconium-stained amniotic fluidAbstract
Background: Meconium-stained amniotic fluid is a frequent obstetrical disorder accompanied with adverse outcomes. The objective of this study is to assess fetal outcome in relation to mode of delivery in pregnant women complicated by meconium-stained amniotic fluid.
Methods: This study was an observational cross-sectional study implemented in High risk and Labor ward of Maternity Teaching Hospital in Erbil city-Kurdistan region/Iraq through the period of one year from 1st of May 2022 to 30th of April 2023 on two hundred pregnant women with meconium-stained amniotic fluid. Maternal factors such as status of membrane, and grade of meconium were assessed. Fetal assessment by APGAR score, birth weight and outcome were analyzed. Fetal follow up continued for one week after birth
Results: Severity and incidence of Meconium staining was classified into; light (28.5%), moderate (51.5%) and thick (20%). Cesarean section delivery was more obvious among pregnant women with latent phase of labor (50%) (p<0.001). The thick meconium was highly related to cesarean section delivery (30.9%), low fetal APGAR score at 1minute (40%), low fetal APGAR score at 5 minutes (11%) and high neonatal intensive care unit admission rate (90%) (p<0.001). This study also showed a significant relationship between low fetal APGAR score at one minute and high (72.5%) neonatal intensive care unit admission (p=0.05) among pregnant women with meconium-stained amniotic fluid delivered by cesarean section (p<0.001).
Conclusions: The thick meconium-stained amniotic fluid and cesarean section delivery are related to poor perinatal fetal outcomes.
Downloads
References
1. Jain PG, Sharma R, Bhargava M. Perinatal outcome of meconium-stained liquor in pre-term, term and post-term pregnancy. IJOGR. 2017; 4(2):146-150.
2. Parween S, Prasad D, Poonam P, Ahmar R, Sinha A, Ranjana R. Impact of Meconium-Stained Amniotic Fluid on Neonatal Outcome in a Tertiary Hospital. Cureus 2022; 14(4): e24464.
3. Addisu D, Asres A, Gedefaw G, Asmer S. Prevalence of meconium-stained amniotic fluid and its associated factors among women who gave birth at term in Felege Hiwot comprehensive specialized referral hospital, North West Ethiopia: a facility based cross-sectional study. BMC Pregnancy Childbirth. 2018;18(1):429. doi: 10.1186/s12884-018-2056-y/
4. Whitsett JA, Rice WR, Warner BB, Wert SE, Pryhuber GS. Acute respiratory disorders. In Avery GB, MacDonald, MG, Seshia, MM., Mullett, MD (eds.), Avery’s Neonatology. Pathophysiology & Management of the Newborn. 6th eds. Philadelphia: Lippincott Williams & Wilkins. 2005; 553-577.
5. Yurdakul Z, Turkoz HK, Bilgen H, Solakoglu S, Kavuncuoglu S, Ozek E. Placental ultrastructural changes and apoptosis in pregnancies with meconium-stained amniotic fluid. Turk Patoloji Dergisi 2012; 28(2):147-199.
6. Van Ierland Y, de Beaufort AJ. Why does meconium cause meconium aspiration syndrome? Current concepts of MAS pathophysiology. Early Hum Dev 2009; 85(10):617-620.
7. Rathoria R, Rathoria E, Bansal U, Mishra M, Jalote I, Shukla NK, et al. Study of risk factors and perinatal outcome in meconium-stained deliveries from a district of Uttar Pradesh, India. Int J Reprod Contracept Obstet Gynecol 2018, 7:3605-3609.
8. Mundhra R, Agarwal M. Fetal outcome in meconium-stained deliveries. J Clin Diagn Res 2013; 7(12):2874-2876.
9. Wong SF, Chow KM, Ho LC. The relative risk of 'fetal distress' in pregnancy associated with meconium-stained liquor at different gestation. J Obstet Gynaecol 2002; 22(6):594-599.
10. Lee J, Romero R, Lee KA, Kim EN, Korzeniewski SJ, Chaemsaithong P, et al. Meconium aspiration syndrome: a role for fetal systemic inflammation. Am J Obstet Gynecol 2016; 214(3): 366.e1-9.
11. Naqvi SB, Manzoor S. Association of meconium-stained amniotic fluid with perinatal outcome in pregnant women of 37–42 weeks gestation. Pak J Surg 2011; 27(4):292–298.
12. Unsworth J, Vause SJO. Meconium in labour. Gynaecol Med R 2010; 20(10):289–294.
13. Ward C, Caughey AB. The risk of meconium aspiration syndrome (MAS) increases with gestational age at term. J Matern Fetal Neonatal Med 2022; 35(1):155–160.
14. Mohammad N, Jamal T, Sohaila A, Ali SR. Meconium-stained liquor and its neonatal outcome. Pak J Med Sci 2018; 34(6):1392–1396.
15. Attali E, Lavie M, Lavie I, Gomez R, Yogev Y, Gamzu R, et al. Prolonged exposure to meconium in cases of spontaneous premature rupture of membranes at term and pregnancy outcome. J Matern Fetal Neonatal Med 2022; 35(25):6681-6686.
16. Duhan N, Paul A, Duhan U, Anjali. Meconium Staining of Amniotic Fluid a Poor Indicator of Fetal Compromise. JK Science 2010; 12 (4): 184-186.
17. Osava RH, Silva FM, Vasconcellos de Oliveira SM, Tuesta EF, Amaral MC. Fatores maternos e neonatais associados ao mecônio no líquido amniótico em um centro de parto normal [Meconium-stained amniotic fluid and maternal and neonatal factors associated]. Rev Saude Publica 2012; 46(6):1023-1029.
18. Dereje T, Sharew T, Hunde L. Meconium-Stained Amniotic Fluid and Associated Factors among Women Who Gave Birth at Term in Adama Hospital Medical College, Ethiopia. Ethiop J Health Sci 2023; 33(2):219-226.
19. Althaqafi A, Ateeq R, Al-Bukhar D, Danish D, Alamoudi R, Abduljabbar H. Fetal Outcome and Mode of Delivery in a Patient with Meconium-Stained Amniotic Fluid. Open J Obstet Gynecol. 2021; 11: 12-19.
20. Jha UC, Dangal G. Fetal Outcome in Cesarean Versus Normal Deliveries in Pregnancy with Meconium-stained Liquor: A Cross-sectional Study. J Nepal Health Res Counc 2021; 19(50): 107-110.
21. Ajibo BD, Wolka E, Aseffa A, Nugusu MA, Adem AO, Mamo M, et al. Determinants of low fifth minute Apgar score among newborns delivered by cesarean section at Wolaita Sodo University Comprehensive Specialized Hospital, Southern Ethiopia: an unmatched case control study. BMC Pregnancy Childbirth 2022; 22(1):665.
22. Aafreen R, Dabral A, Panwar M, Tripathi A. Cord blood parameters and fetal outcome in neonates with fetal distress due to meconium staining liquor- an observational study. Int J Reprod Contracept Obstet Gynecol 2022; 11:3074-3079.
23. Lungameni J, Nghitanwa EM, Uusiku L, Karera A. Maternal factors associated with immediate low Apgar score in newborn babies at an intermediate hospital in Northern Namibia. J Public Health Afr 2022; 13(3):2045.
24. Nath P. Meconium-stained amniotic fluid: A correlation with mode of delivery and perinatal outcome. New Indian j. OBGYN (Online). 2018; 4(2): 158 –-160.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Shukriyah Taha Omar Ababakir, Awat Ibrahim Hamadamen
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The copyright on any article published in AMJ (The Scientific Journal of Kurdistan Higher Council of Medical Specialties )is retained by the author(s) in agreement with the Creative Commons Attribution Non-Commercial ShareAlike License (CC BY-NC-SA 4.0)
