Evaluation of Perinatal Outcome in Meconium Stained Liquor A Tertiary Care Teaching Hospital-Based Study

Abstract

Aim: To evaluate the frequency, mode of delivery, and perinatal outcomes associated with MSAF at a tertiary care teaching hospital.

Methods: A prospective observational study was conducted in the Department of Obstetrics and Gynaecology, Associated Hospital, Government Medical College, Doda, over a period of one year. Pregnant women with singleton, cephalic pregnancies at ≥37 weeks of gestation who developed MSAF following spontaneous or artificial rupture of membranes were included. Women with multiple pregnancy, gestation <37 weeks, non-cephalic presentation, intrauterine death, or congenital malformations were excluded. A total of 124 women were enrolled by convenience sampling. Maternal characteristics, meconium consistency, mode of delivery, APGAR scores, NICU admission, respiratory support, and perinatal outcomes were assessed. Statistical analysis was performed using SPSS version 20.0, with the chi-square/Fisher exact test used for categorical variables. A p-value <0.05 was considered statistically significant.

Results: The mean maternal age was 23.03±2.79 years, and 54.8% of women were primigravida. The mean gestational age was 38.15±1.75 weeks. Thick and thin meconium accounted for 50.8% and 49.2% of cases, respectively. Thick meconium was significantly associated with unbooked status (p=0.002) and maternal anemia (p=0.003). LSCS was more frequent in women with thick meconium than thin meconium (68.3% vs. 50.8%; p=0.04). Low APGAR scores were significantly more common with thick meconium at both 1 minute (p=0.01) and 5 minutes (p=0.001). NICU admission and duration of stay were significantly associated with meconium consistency (p=0.001). CPAP requirement was higher in thick MSAF (14.3% vs. 1.6%; p=0.01), whereas nasal-prong oxygen use was higher in thin MSAF (24.6% vs. 6.3%; p=0.005). MAS (12.7% vs. 0%; p<0.001) and HIE (14.3% vs. 1.6%; p=0.01) were significantly more frequent in thick MSAF.

Conclusion: Thick MSAF was associated with increased operative delivery, lower APGAR scores, prolonged NICU requirements, greater need for respiratory support, and higher rates of MAS and HIE. Adequate antenatal care, early identification of maternal risk factors, vigilant intrapartum fetal monitoring, and timely neonatal intervention are essential to reduce adverse perinatal outcomes associated with MSAF.