A Comparative Study on Feto-Maternal Outcome in Patients with Meconium Stained Liquor Vs Clear Liquor

Abstract

INTRODUCTION Nature has provided the foetus with many protective mechanisms against many intra uterine hazards. One such protection is Amniotic fluid, the quantity varies , increasing with growing foetus, till term. In early pregnancy it is colourless and at term is become pale straw coloured. Abnormal colours of fluid during pregnancy indicates different pathologies. Meconium stained liquor is a matter of concern as it causes intra-natal asphyxia, matter neonatal outcome, and so, increases the rates of caesarean section, albeit as a salvation measure. Deliveries complicated with meconium stained liquor are associated with increased operative delivery and additional morbidity & mortality in pregnancy outcomes. Birth asphyxia due to meconium aspiration syndrome results in increase in NICU admission. MATERIAL AND METHODS This study was done in Dhiraj Hospital in Obstetrics and Gynecology department. It was prospective observational study. The study duration was 1.5 year. It comprises of patients, who had reported to hospital for regular antenatal check-ups and admitted in obstetrics and gynecology ward.Patients who fulfilled the inclusion criteria were included in the study. Delivery will be expedited, when fetal heart rate abnormalities will be detected, by safest mode of delivery, either by instrumental vaginal delivery, or caesarean section. The APGAR score of neonates at 1minute and 5 minutes, birth weight, NICU admission, the neonates who had meconium aspiration syndrome, number of days of hospitalization and birth asphyxia will be recorded. XI RESULT As per the mode of delivery concerned, increased incidence of cesarean section was seen and was significantly associated with the consistency of meconium compared to clear liquor.Meconium stained amniotic fluid is significantly associated with nonreactive NST (P < 0.05) compare to clear liquor. This should be taken as a potential danger sign for the baby and the need for early intervention. Neonates with thick meconium, as compared to those with thin meconium appeared to have significantly greater rates of hypoxia, low APGAR score at 1 min and 5 min, need for resuscitation and required more NICU admission. CONCLUSION: In antenatal period- By encouraging the patient for regular antenatal clinical visits, providing proper antenatal care, can help in early diagnosis of high risk cases. It can help in reducing the severity of complications .In Intra-partum period – Proper monitoring of patients by following parameters like fetal heart sound, uterine contractions, fetal movements. We can reduce the incidence of fetal hypoxia. If fetal hypoxia occurs , it can be prevented in initial stage by giving left lateral position, adequate oxygen supply, Injection soda bicarbonate in ringer lactate. This can prevent acidotic medium.