MECONIUM STAINED AMNIOTIC-FLUID IN VERY-LOW RISK PREGNANCIES AT TERM GESTATION

Objective: To determine the prevalence and clinical significance of me conium stained amniotic fluid (MSAF) in a low risk population at term gestation and to investigate whether MSAF is a predictor for intrapart um and neonatal morbidity. Methods: A very low risk population includi ng 37 085 consecutive deliveries at term composed the study population . A cross-sectional study was conducted and two groups of patients wer e identified according to the presence (n=6164) or absence (n=30 921) of meconium in the amniotic fluid at delivery and the outcomes of the two groups compared. Results: The prevalence of MSAF was 16.6%. The in cidence of cesarean section (5.6% vs 2.3% P<0.01), instrumental delive ries (3.2% vs 1.8% P<0.01), fetal distress (6.5% vs. 2.1% P<0.01), cli nical chorioamnionitis (0.2% vs. 0.1% P<0.01), post-partum infection ( 0.5% vs. 0.2% P<0.01), 1-minute Apgar score <3 (1.9% vs. 1.1% P<0.01), small for gestational age (7.4% vs. 6.4% P<0.01). was significantly h igher in the MSAF compared with the clear amniotic fluid group. Intrap artum and neonatal mortality in this low risk population was significa ntly higher in the MSAF group (1.7/1000) compared with women with clea r AF (0.3/1000). Conclusions: MSAF in a low risk population at term ge station is a predictor for adverse perinatal outcome and peripartum co mplications. (C) 1998 Elsevier Science Ireland Ltd. All rights reserve d.