Variables associated with meconium aspiration syndrome in labors with thick meconium

Objective: To examine the possible maternal and fetal variables associated with meconium aspiration syndrome in labors with thick meconium. Study desi gn: The Fetal heart rate tracings, cord pH, Apgar scores and maternal risk factors were evaluated in singleton pregnancies with vertex presentation an d thick meconium in labor. The study included 33 consecutive fetuses which developed a moderate or severe meconium aspiration syndrome and 104 consecu tive fetuses which had a favorable outcome. Results: Significant difference s between fetuses with meconium aspiration syndrome and healthy fetuses wer e found in the following parameters: baseline FHR (154+/-17 vs. 136+/-10, P < 0.0001), small accelerations/30 min (1.47+/-1.52 vs. 3.04+/-1.2, P < 0.0 001), large accelerations/30 min (1.46+/-1.96 vs. 3.5+/-2.31, P < 0.0003), decelerations/30 min (4.9+/-3.9 vs. 2.4+/-2.1, P < 0.0034), number of fetus es with reduced beat-to-beat variability (9/33 vs. 0/104, P < 0.0001), cord pH (7.21+/-0.09 vs. 7.33+/-0.08, P < 0.0013) and Apgar scores at 1 min (5/-2 vs. 8+/-1, P < 0.0001) and Apgar scores at 5 min (8+/-2 vs. 9.7+/-0.6, P < 0.0001). Maternal risk factors were found in two of 33 sick infants and in 13 of 104 healthy infants. Conclusion. Thick meconium by itself is: not associated with adverse fetal outcome. However, the incidence of meconium aspiration syndrome increases in cases of a non-reassuring FHR. (C) 2001 El sevier Science Ireland Ltd. All rights reserved.