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Meconium: a 1990s perspective on an old obstetric hazard
L Nathan1, K J Leveno, T J Carmody
1Department of Obstetrics and Gynecology, University of Texas Southwestern Medical School, Dallas.
Obstetrics and Gynecology
|March 1, 1994
Summary
Meconium in amniotic fluid (AF) is linked to increased risks for newborns. This study found higher rates of fetal-neonatal complications and mortality when meconium is present during labor.
Area of Science:
- Obstetrics and Gynecology
- Neonatal Perinatal Medicine
- Fetal Medicine
Background:
- Meconium staining of amniotic fluid (AF) is a common intrapartum finding.
- The precise perinatal risks associated with meconium-detected AF require ongoing quantification.
Purpose of the Study:
- To quantify the perinatal consequences of intrapartum meconium detection in amniotic fluid.
Main Methods:
- Retrospective comparison of outcomes in term singleton cephalic pregnancies.
- Analysis of 8136 pregnancies with meconium-stained AF versus 34,573 with clear AF.
Main Results:
- Significantly increased adverse fetal-neonatal outcomes were observed with meconium.
- Perinatal mortality rose from 0.3 to 1.5 per 1000 births; severe fetal acidemia increased from 3 to 7 per 1000.
- Cesarean delivery rates doubled from 7% to 14% in the presence of meconium.
Conclusions:
- Meconium in AF presents an obstetric hazard.
- Presence of meconium is associated with small but statistically significant increases in adverse fetal-neonatal outcomes.