Frequency of meconium stained liquor in low risk laboring women and its effect on perinatal outcome in a tertiary care hospital.

Abstract

Objective: To evaluate the frequency of meconium stained liquor (MSL) in low risk women and its effect on perinatal outcomes. Study Design: Prospective Case Control study. Setting: Department of Obstetrics and Gynecology Military Hospital, Rawalpindi. Period: January to August 2017. Material & Methods: Distribution of MSL was studied according to its grade. Data included demographic profile, mode of delivery, intrapartum factors and neonatal outcomes. Descriptive statistics and chi-square were used for analysis. Results: Frequency of MSL was 376 (3.65%) among 10,281 deliveries during study period. A total of 752 women were included in the study which were divided into cases and controls. Nulliparity and advanced gestational age were significantly associated with MSL. Distribution of grade of meconium was 20.5%, 56.4% and 23.1% for grade I, II and III MSL. Breech presentation, fetal heart rate abnormalities and cesarean section were significantly associated with MSL. Low apgar score at 1 and 5 minutes, Neonatal intensive unit care admissions and fetal complications had positive correlation with MSL. Frequency of meconium aspiration syndrome (MAS) was 16.4%, birth asphyxia 5.31% and respiratory distress syndrome (RDS) 1.32% amongst all the cases of MSL. However, frequency of MAS, birth asphyxia and RDS was 0.6%, 0.19%, 0.02% in general obstetric population. Neonatal mortality was 29% in MAS, 3.4% in MSL and 0.12% in general population. Adverse neonatal outcomes had positive correlation with increasing grade of meconium. Conclusion: There is a significant frequency of meconium stained liquor even in low risk women. MSL is significantly associated with increased cesarean section rates and adverse neonatal outcomes.