Korean J Perinatol.  2008 Sep;19(3):269-276.

Perinatal outcome of term pregnancies with meconium-stained amniotic fluid

• Kwon JY
• Shin JE
• Ahn SY
• Lee G
• Kim SJ
• Shin JC
• Park IY

Abstract

PURPOSE: The purpose of this study was to compare the obstetric and perinatal outcome between two groups with or without meconium staining of amniotic fluid (MSAF) at term birth in one-year consecutive population at our delivery unit.
METHODS
Pregnancy complication including nonreassuring fetal heart rate pattern, intrauterine growth retardation, oligohydramnios, hydramnios and preeclampsia between the two groups were retrospectively documented by review of medical record. To evaluate the perinatal outcome, apgar score at 1min and 5min, and umbilical artery blood gas analysis were also analyzed. Student T test and chi square test were used for statistic analysis.
RESULTS
The study population consisted of 687 full-term neonates with presence (n=89) and absence (n=598) of MSAF. Gestational age at delivery was significantly higher in the MSAF group (p< 0.001). Although the fetal acidemia (umbilical artery blood pH <7.0) was significantly higher in the MSAF group (3.4% vs 1.0%, p<0.01), the metabolic acidemia (base deficit >12.0 mEq/L) was not increased. The incidence of non reassuring fetal heart rate pattern was also increased in the MSAF group (4.5% vs 1.0%, p=0.03). However there was no significant difference in 1 min and 5 min Apgar score.
CONCLUSION
Although MSAF is associated with the risk of non reassuring fetal heart rate pattern and fetal acidemia, the metabolic acidemia and low apgar score at 5minutes was not significantly increased compared with clear amniotic fluid group. Delivery of pregnancy with MSAF should be managed under the careful fetal heart rate monitoring.

Keyword

Meconium staining; Fetal acidemia; Nonreassuring fetal heart rate pattern; Apgar score

MeSH Terms

Amniotic Fluid
Apgar Score
Arteries
Blood Gas Analysis
Female
Fetal Growth Retardation
Gestational Age
Heart Rate, Fetal
Humans
Hydrogen-Ion Concentration
Incidence
Infant, Newborn
Meconium
Medical Records
Oligohydramnios
Polyhydramnios
Pre-Eclampsia
Pregnancy
Pregnancy Complications
Retrospective Studies
Term Birth
Umbilical Arteries