Hill Publishing Group | contact@hillpublisher.com

Hill Publishing Group

Location:Home / Journals / International Journal of Clinical and Experimental Medicine Research /


Prevalence and Factors Associated with Meconium Staining of Amniotic Fluid, Meconium Aspiration Syndrome and Clear Liquor in South Indian New-born—Part II

Date: August 13,2020 |Hits: 4529 Download PDF How to cite this paper

Grace Lalana Christopher

Grace Specialist Clinic, #6, 1st Floor, Maruthi Complex, Ramamurthynagar Main Road, Bangalore 560016, South India.

*Corresponding author: Grace Lalana Christopher


Meconium staining of amniotic fluid (MSAF) is a commonly observed phe-nomenon in day-to-day practice of obstetrics, advocates the quick delivery of baby as priority since majority 84% of newborns with MSAF were asphyxiated at birth OR 8.42 [CI95%] 5.1-14, P=0.0001 compared to those newborns with clear liquor. The prevalence of MSAF 7.8% however incidence of Meconium Aspiration Syndrome (MAS) was 1.8%, but constituted 23% of MSAF parturient. Various high risk factors include primigravida, young mothers with obstetric complications of premature rupture of membranes (PROM) of more than one hour before labor occurred in 9.1% of 207MSAF pregnancies compared to only 7.3% in overall births. Similarly also Pregnancy induced hypertension (PIH) occurred in 9% with MSAF compared to an overall 5.6%. Gestational diabetes (GDM) was least 3.4% in MSAF pregnancies compared to overall 5.3%. While Grade II MSAF peaked in birth weight category 300-3499g category, most newborn of remaining parturient weighed between 2,500-2,999g. Peak births at 38 weeks comprised of newborns with clear liquor delivered normally, contrasted to peak births at 39 weeks for newborns with MSAF and MAS delivered mainly by emergency Lower Segment Caesarean Section (LSCS). Surprisingly commonest parturient blood group was AB+ve. In conclusion, effective preventive strategy would be early delivery by 38 weeks gestation preferably by elective LSCS, obviating intra-partum events in high risk cases, resulting in improvement of fetal and neonatal morbidity and mortality.


[1] Arun, H., Nayak, A., and Dalal R. (1991). Meconium staining of amniotic fluid- Significance and fetal outcome. Indian Jl OBG Aug 41(4): 480-83.

[2] Cleary, G. M. and Wisell, T. E. (1998). MSAF and MAS an update Pediatrics Clinics of North America. Vol. 45, No. 3 pp. 511-529. 

[3] Bardley, A. Yoder, E. A. Kirsch, William H. B., and Michael G. C. (2002). Changing obstetric practices associated with de-creasing incidence of meconium aspiration syndrome. Am J Obset Gynecol, 99(5): 731-39.

[4] Addisu, D., Asres, A., Gedefav, G. and Asmer, S. et al. (2018). Prevalence of Meconium stained Amniotic fluid and factors among women who gave birth at term in Felege Hivot Comprehensive specialized hospital, North West Ethiopia: A facility based cross-sectional study. BMC. Pregnancy and Childbirth, 18: 429. 

[5] Khazardoost, Hanloushzadeh, S., Khooshideh, M., and Borna, S. (2007). Risk factors for Meconium aspiration in Meconium stained Amniotic fluid. J Obstet Gynecol 27(6): 577-579.

[6] Miller, F. C., D. A. Sachs, S. Y. Yeh, et al. (1975). Significance of meconium during labor. Am J Obstet Gynecol 122(5): 573-580.

[7] Katz, L. V. and Bowes W. A. (1992). Meconium aspiration syndrome, reflection on a musky subject. Am. J. Obstet & Gynaecol 166: 171-183.

[8] Gabbe, S. G., Ettinger, B. B., Freeman, R. K., and Martin, C. B. (1976). Umbilical cord compression associated with amniotomy: laboratory observations. Am J Obstet Gynecol, 126(3): 353-355. 

[9] Abramovici, H., Brandus, T. H., Fuchs, K., and Timor-Tritsch, I. (1974). Meconium during delivery, a sign of compensated fetal distress. Am J. Obset & Gynaecol 118(2): 251-255.

[10] Hon, E. H., Brad, Field, A. M. and Hessow. (1961). The electronic evaluation of the fetal heart rate. Am. J. Obstet Gynecol, (82): 291

[11] Socol, M. L., Garcia, P. M., and Riter, S. (1994). Depressed Apgar scores, Acid-base status, and neurologic outcome. Am J Obset Gynoco, 170(4): 991.

[12] Starks, G. C. (1980). Correlation of meconium stained amniotic fluid, early intrapartum fetal pH an Apgar scores as predictors of perinatal outcome. Journal of Obstet & Gynaecol 56: 604.

[13] Jovanovic, R. and Nguyen, H. T. (1989). Experimental meconium aspiration in guinea pigs. Obstet & Gynecolvol, 73(4): 652-656.

[14] Keszler, Martin. (2015). “Sustained inflation during neonatal resuscitation” Current Opinion in Pediatrics.

[15] Chua, B. A., Chan, L., Kindker, P. M., and Perks, A. M. (2000). “The association between meconium and the production and reabsorption of lung liquid and lactate loss by in vitro lungs from fetal guinea pigs”. Am J Obstet & Gynecol 183(1): 235-244.

[16] Gooding, C. A., Gregory, G. A., and Taber, P. (1971). An experimental model for the study of meconium aspiration of the new born. Radiology, 100(1): 137.

[17] Florman, A. l. and Tuebner, D. (1986). Enhancement of bacterial growth in amniotic fluid by meconium. J Pediatr, 74(1): 111.

[18] Romero, R., Hanaoka, S., and Mazor, M. et al. (1991). Meconium stained amniotic fluid: A risk factor for microbial invasion of the amniotic cavity. Am. J. Obset& Gynaecol 16(3): 859-862.

[19] Clark, P. and Duff, P. (1995). Inhibition of neutrophil oxidative burst and phagocytosis by meconium. Am J Obstet Gynecol. 173(4): 1301.

[20] Murphy, J. D., Rabinovitch, M., and Goldsteen, J. D. (1991). The structural basis of persistent pulmonary hypertension of the newborn infant. J Pediatr, 98(6): 962-967.

[21] Periman, I., Moore, G. W., and Hutchins, G. M. (1989). The pulmonary vasculature in meconium aspiration. Human pathology 20(7): 701-706.

[22] Tyler, D., Murphy, J., and Chenny, F. W. (1978). Mechanical and chemical damage to lung tissue caused by meconium aspiration. Jr. Pediatrics, 62: 454-59.

[23] Vidyasagar, Yeh, T. F., and Harris, V. (1975). Assisted ventilation in infants with meconium aspiration syndrome. Pediatrics J., 56: 208.

[24] Ostrea, Jr. E. M. and Naqvi, M. (1982). The influence of gestational age on the ability of the fetus to pass meconium in utero: clinical implications. Acta Obstetricia et Gynecological Scandinavica, 61(3), pp. 275-277. 

[25] Fenton, A. N. and Steer, C. M. (1962). Meconium in utero, a sign of fetal maturity. Am. J. Obstet & Gynaecol, 83: 354.

[26] Piui, T. What I the most common blood type? zmescience.com/science/m 

[27] Grace Lalana Christopher. (2018). The effect of biological factors on Birth weight and Gestation in South Indian Newborns. J Pediatr Neurol Med., 3(1), pp. 97-103. DOI: 104172/2472-100X1000130.

[28] Benacerrf, B. R., Gatter, M. A., and Ginsburgh, F. (1984). Ultrasound diagnosis of meconium-stained amniotic fluid. Am J obset gynecol, 149(5): 570-572.

[29] Hill, L. M. and Breckle, R. (1998). Vernix in amniotic fluid: Sonography detection. Radiology, 158(1): 80.

[30] Saling, E. W. (1966). Amnioscopy. J. of Clinical Obstet & Gynaecol 9: 472.

[31] Wyckoff, M. H., Aziz, K., Esobedo, M. B., Kapadia, VS et al. (2015). Part 13: neonatal resuscitation: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular care. Circulation, 132 (suppl 2): S543-S560.

[32] Kubli. (1988). Significance of second stage fetal heart rate abnormalities. Am J. Obset& Gynaecol 60: 330-32.

[33] Alfirev, Z., Devane, D., and Gyte, G. M. (2006). Continuous Cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labor. Cochrane Database of Systematic Reviews No. 3; Article ID CD006066, 2006.

[34] Kuhnert, M., Seelbach-Goebel, B., and Butterwegge, M. (1998). Predictive agreement between the fetal arterial oxygen saturation and fetal scalp pH: results of the German multicenter study. Am J Obstet Gynecol, 178(2): 330-335. 

[35] Low, J. A. and Piercy, W. N. (1981). The prediction of intrapartum fetal metabolic acidosis by fetal heart rate monitoring. Am J Obstet Gynecol, 139(3), Feb, pp. 299-305.

[36] Nicholas, Johnson. (1994). “Fetal Pulse Oximetry: A new method of monitoring the Fetus”. The Australian and New Zealand Journal of Obstetrics and Gynecology, 34(4): 428-432.

[37] Velaphi, S. and Vidyasagar, D. (2006). Intrapartum and post-delivery management of infants born to mothers with MSAF: evidence based recommendation. Clinics in Perinatology, 33(1): 29-42. 

[38] Wiswell, T. E. (2008). Delivery room management of the meconium stained newborn. Journal of Perinatology, 28(suppl. 3): S19-26.

[39] Schmolzer, G., M., Kumar, M., and Pichler, G. et al. (2013). Non-invasive versus invasive respiratory support in preterm infants at birth: systematic review and meta-analysis. BMJ. 2013; 347 doi: https:/doi.org/10.1136/bmj.f5980 (published 17 October 2013).

[40] Kinella, J. P., Truog, W. E., and Walsh, W. F. et al. (1997). Randomized multicenter trial of inhaled nitric oxide and high fre-quency oscillatory ventilation in severe, persistent pulmonary hypertension of the newborn. J Pediatr., 131(1), part 1, pp. 55-62. 

[41] Dargaville, P. A., Copnell, B., and Mills, J. F. et al. (2011). Randomized controlled trial of lung lavage with dilute surfactant for meconium aspiration syndrome. J Pediatr, 158(3), pp. 383-389.

How to cite this paper

Prevalence and Factors Associated with Meconium Staining of Amniotic Fluid, Meconium Aspiration Syndrome and Clear Liquor in South Indian New-born—Part II

How to cite this paper: Grace Lalana Christopher. (2020) Prevalence and Factors Associated with Meconium Staining of Amniotic Fluid, Meconium Aspiration Syndrome and Clear Liquor in South Indian New-born—Part II. International Journal of Clinical and Experimental Medicine Research, 4(4), 126-137.

DOI: http://dx.doi.org/10.26855/ijcemr.2020.10.003

Volumes & Issues

Free HPG Newsletters

Add your e-mail address to receive free newsletters from Hill Publishing Group.

Contact us

Hill Publishing Group

8825 53rd Ave

Elmhurst, NY 11373, USA

E-mail: contact@hillpublisher.com

Copyright © 2019 Hill Publishing Group Inc. All Rights Reserved.