Meconium-stained liquour associated with unfavourable maternal and neonatal outcomes: Study
Meconium, the first intestinal contents of a developing fetus and the newborn's initial bowel movement, can appear green, brown, or yellow. The correlation between Meconium- Stained Amniotic Fluid (MSAF) with fetal outcomes and associated risk factors has been thoroughly researched. Meconium-stained amniotic fluid (MSAF) is linked to higher rates of operative births, adverse neonatal outcomes, and increased NICU admissions. However, careful labour management, including continuous fetal heart rate monitoring, can help minimize unnecessary cesarean sectionsin pregnancies with MSAF. While fetal stress near delivery can sometimes trigger meconium expulsion, full-term newborns typically pass their first meconium within the first day after birth.
The observation of meconium-stained amniotic fluid during delivery necessitates immediate involvement of a neonatal resuscitation team. The presence of meconium- stained amniotic fluid has been found to be a significant predictor of adverse maternal and perinatal outcomes. A substantially higher risk of perinatal asphyxia, non- reassuring fetal heart rate patterns, neonatal sepsis, meconium aspiration syndrome, NICU admission, early neonatal death, operative delivery, and puerperal sepsis in meconium-exposed cases has been found emphasizing the critical need for focused intrapartum and postnatal care for these mothers.
Fetal distress, gestational age, delivery by lower uterine segment cesarean section (LSCS), and prolonged labour significantly increase the risk of meconium staining at birth. Recognizing these factors can facilitate early identification of complications and improved management of meconium- stained neonates.
The aim of the study was to compare the neonatal and maternal outcomes in term pregnancies associated with meconium-stained amniotic fluid versus with clear amniotic fluid. The objectives of the study included determination of incidence of meconium-stained amniotic fluid (MSAF) in a low-risk population at term gestation, to determine the incidence of clear stained amniotic fluid in a low-risk population at term gestation and to compare the feto-maternal outcomes in MSAF and clear amniotic fluid.
The study was an observational case control study which studied the feto-maternal outcomes between 55 cases of meconium-stained amniotic fluid and 55 cases of clear amniotic fluid.
The incidence of Meconium-Stained Liquor (MSL) was found to be 2.74%. 55 cases of meconium staining of liquor and 55 cases with clear amniotic fluid were included in the study. MSL was associated with unfavourable maternal and neonatal outcomes and was observed to be positively correlated with increasing maternal age and period of gestation. More number of babies had fetal distress in MSL group, thereby requiring resuscitation and NICU admissions. MSL was also associated with development of Meconium aspiration syndrome and neonatal mortality. Also higher caesarean section rate was observed in the MSL group.
The incidence rate of MSL was 2.74% in present study. Meconium stained liquour was associated with unfavourable maternal and neonatal outcomes and was observed to be positively correlated with increasing maternal age and period of gestation. More number of babies had fetal distress in MSL group, thereby requiring resuscitation and NICU admissions. As MSL was associated with increased incidence of fetal distress, higher caesarean section rate in the MSL group was also observed. The diagnosis of Meconium-stained liquor should alert the obstetrician to potential fetal distress and encourage increased vigilance in managing such cases by close feto-maternal monitoring. This study is representative of a low-risk population in a tertiary care centre and demonstrates stark difference from studies performed in high- risk populations in terms of incidence. The detection of meconium stained liquor at proper time can prevent sinister fetal outcomes.
Source: Thakker et al. / Indian Journal of Obstetrics and Gynecology Research 2026;13(2):293–299
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