Meconium-stained amniotic fluid in term pregnancies-a clinical view

The objective of this study was to explore details of the clinical relationship between meconium-stained amniotic fluid (MSAF) in labour, abnormal fetal heart pattern and meconium aspiration (MA). This was a prospective study carried out in Princess Badeea Teaching hospital during a 6-month period from March to September 1997. During the study period 344 (8.5%) of the deliveries had MSAF (344 women). Continuous fetal heart monitoring was routinely used and 36 women with MSAF (10.5%) needed to be delivered by caesarean section because of fetal distress (diagnosed by abnormal fetal heart pattern) in early labour, compared with 0.95% in those with clear amniotic fluid (CAF), (P <0.00001). Many infants in the MSAF group had a low Apgar score and required ventilation at birth. Nineteen infants (5.5%) developed MA, three of whom (15.8%) died. We conclude that there is an association between MSAF, abnormal fetal heart pattern in labour and a low Apgar score and that it should be considered a high risk situation. MA a problem that occurs with particulate meconium was significantly related to abnormal fetal heart pattern and longer length of labour.