Maternal and Perinatal Outcome in Meconium-stained Amniotic Fluid: A Hospital-based Observational Study

Meconium-stained amniotic fluid (MSAF) is a commonly encountered finding during labor, particularly in term and postterm pregnancies, and is frequently associated with increased maternal and perinatal morbidity. The presence of meconium in the amniotic fluid is often viewed as a marker of fetal compromise, especially when thick or associated with abnormal fetal heart rate patterns. Timely identification and appropriate obstetric interventions are essential to mitigate adverse outcomes for both the mother and the neonate.

The aim of the study was to evaluate the maternal and perinatal outcomes associated with MSAF and to compare clinical parameters between thin and thick meconium consistency.

This hospital-based observational study was conducted in the Department of Obstetrics and Gynaecology, Dr. D. Y. Patil Medical College, Pimpri, Pune, over a period of 12 months from January 2023 to December 2023. A total of 100 term pregnant women with singleton pregnancies in labor and documented MSAF were included. Patients were grouped based on meconium consistency into thin ( n = 53) and thick ( n = 47) MSAF categories. Maternal variables assessed included mode of delivery, duration of labor, and intrapartum complications. Neonatal outcomes evaluated were birth weight, Apgar score, neonatal intensive care unit (NICU) admission, and presence of meconium aspiration syndrome (MAS). Data were analyzed using SPSS version 22, and P < 0.05 was considered statistically significant.

Among the 100 cases, 53% had thin meconium and 47% had thick meconium. Thick MSAF was significantly associated with higher rates of cesarean section, fetal distress, MAS, and NICU admissions compared to the thin MSAF group. A lower Apgar score at 1 and 5 min was also more frequently observed in the thick MSAF group. Instrumental deliveries were more common in the thin MSAF, while spontaneous vaginal delivery rates were lower in the thick MSAF subgroup.

The presence and consistency of meconium in amniotic fluid are important indicators of fetal compromise. Thick meconium, in particular, is significantly associated with adverse perinatal outcomes and a higher rate of obstetric intervention. Careful monitoring during labor and timely decision-making regarding the mode of delivery can help reduce maternal and neonatal complications associated with MSAF.