Perinatal outcome in relation to mode of delivery in Meconium-Stained Neonates

Abstract

Objective: Meconium-stained amniotic fluid (MSAF) occurs in 7-22% of term pregnancies. It is less common before 38 weeks and more common after 40 weeks of pregnancy and associates with increased perinatal mortality and morbidity. The aim of this study was to determine if the perinatal outcome is affected by mode of delivery in meconium-stained amniotic fluid. Methodology: Five hundred meconium stained neonates born at Alzahra Hospital were studied from 2008 to 2010. All pregnancies were at 36-42 weeks, single fetus, cephalic presentation and normal fetal heart rate pattern. Umbilical cord arterial blood gasses were analyzed immediately after delivery. Perinatal outcome was compared in normal vaginal delivery (NVD) and cesarean section (CS) groups. Results: From 500 meconium-stained neonates 73 were born through (NVD) and 427 by CS. Two groups were not significantly different for the maternal age, gestational age and meconium concentration. Although the mean PH was in normal range (PH>7.2) and mean 1st min & 5th min Apgar scores were higher than 8 in two groups, mask ventilation, intubation and suctioning, respiratory distress and admition in NICU were significantly higher in NVD group. Serious complications like MAS and asphyxia were not statistically different between groups. Conclusions: According to the results of this study it is advisable that cesarean section be limited in MSAF to abnormal fetal heart rate pattern and PH<7.2.