Evaluation and Association of Meconium-Stained Amniotic Fluid With Fetal Distress.

Background Meconium-stained amniotic fluid (MSAF) often leads to complicated deliveries ranging from instrumental delivery, cesarean delivery, and neonatal complications like fetal distress, neonatal intensive care unit (NICU) admission, and neonatal death. Therefore, this study aimed to evaluate the prevalence of MSAF in fetal distress, to determine the clinical profile of newborns in terms of risk factors, and to study the association between antenatal or intra-natal risk factors with MSAF, between umbilical cord pH and MSAF, between stage of labor and MSAF, and between fetal distress and MSAF. Methods A total of 200 cases were enrolled after the diagnosis of fetal distress in the intrapartum period in this observational, non-interventional, and cross-sectional study. The inclusion criteria involved pregnant women who had intrapartum fetal distress diagnosed by the abnormal fetal heart rate findings on cardiotocography (CTG) and the interpretation of CTG, adapted from the National Institute for Health and Care Excellence (NICE) Clinical Guideline 190, was used to classify CTG as abnormal irrespective of underlying causes, mode of delivery by cesarean section, and who were willing to participate. The retrospective and prospective data were collected from the labor room records, and statistical analysis was conducted. Results The study aimed to evaluate the prevalence of MSAF in fetal distress, for which 52/200 (26%) women were reported with moderate MSAF as an obstetric risk factor. A total of 66/200 (33%) women showed a significant association of antenatal or intra-natal risk factors with MSAF. However, an association between umbilical cord pH and MSAF, and between stage of labor and MSAF, was found to be insignificant. Fetal distress was reported to be significantly associated with MSAF, with 41/200 (20.5%) women reporting variable deceleration and 20/200 (10%) reporting late deceleration. Conclusion Moderate MSAF is accounted for as an obstetric risk factor. The association of MSAF with antenatal or intra-natal risk factors was also reported to be significant for obstetric risk factors. But, an association between umbilical cord pH and MSAF, and between stage of labor and MSAF, was found to be insignificant. However, the association between MSAF and fetal distress was significant, indicating the increasing number of cesarean sections being performed for fetal distress. The study reports the association, whereas the future scope might inculcate the strength of the association using odds ratio or prevalence ratio.