Meconium Stained Amniotic Fluid: 10 Years After [12R]. (May 2017)

• Record Type: Journal Article
• Authors: Tilstra, Matthew; Guzman, Angela; Peart, Mishka; Carlan, Steve; McWhorter, Jeannie
• Is Part Of: Obstetrics and gynecology. Volume 129 (2017)Supplement 1
• Publication Date: 2017-05
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/01.AOG.0000514157.71008.81
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : INTRODUCTION: Meconium stained amniotic fluid (MSAF) occurs in 10-20% of deliveries, and, in the past, was considered a reason to alter obstetric and newborn management. Over the past decade, however, otherwise uncomplicated pregnancies characterized by MSAF have been managed regardless of the presence of MSAF. Whether the changes in hospital protocol regarding MSAF have resulted in poorer pregnancy outcomes have not been studied. The purpose of this study was to compare the outcomes of MSAF versus no MSAF pregnancies since hospital protocol removed MSAF as a risk factor for modifying management. METHODS: This was a retrospective study of all 45, 961 singleton deliveries from 12/2009 to 12/2013. MSAF occurred in N=4, 917. RESULTS: Newborn weight and gestational age at delivery were higher in the MSAF group (3344 ± 539 versus 3185 ± 645 grams, and 39 ± 1.8 versus 38 ± 2.5 weeks, respectively, P less than .05. The incidence of Cesarean delivery, and NICU admission were higher and Apgars lower in the MSAF, but umbilical cord pH was similar. CONCLUSION: This study suggests that MSAF influences subjectively assigned Apgar scores, but umbilical cord pH, an objective measure of fetal wellbeing is not different. Abandoning hospital protocols that included obstetric management changes when MSAF was present did not influence umbilical cord pH.