Troubled Waters: The Hidden Risks of Meconium-Stained Liquor

Background: Meconium is a dark green substance made up of shed cells, mucus, and bile that usually accumulates in the fetal intestines and is expelled after birth. When meconium is present in the amniotic fluid, it is often regarded as an indicator of fetal distress, which can be associated with negative perinatal outcomes. This study aimed to investigate the different grades of meconium-stained amniotic fluid and their effects on immediate maternal and neonatal outcomes. Methods: This prospective observational study was conducted from May 2023 to June 2024 at Karuna Hospital, Sendhwa, Madhya Pradesh. The study included 54 women with singleton pregnancies of gestational age ≥35 weeks presenting with meconium-stained amniotic fluid during labour. Continuous fetal monitoring using cardiotocography was performed. Maternal outcomes (delivery mode) and neonatal outcomes (APGAR scores, NICU admissions, neonatal complications) were documented and analyzed. Results: Out of 54 cases, 37 (68.1%) were delivered by caesarean section, while the remaining 17 (31.9%) were delivered vaginally. Differences in delivery methods were observed based on meconium thickness (χ² = 20.66, p < 0.001). Caesarean delivery rates were higher in cases of moderate meconium (59.5%) and thick meconium (29.7%) compared to cases of thin meconium (10.8%). Furthermore, APGAR scores significantly improved from the first to the fifth minute (p < 0.05). NICU admissions were notably higher for thick meconium cases (58.3%) and moderate meconium cases (41.7%), which was statistically significant (p < 0.05). Complications reported included birth asphyxia (16.66%), meconium aspiration syndrome with pneumonia (3.7%), and neonatal sepsis (1.85%). Conclusion: The findings of this study indicate that MSAF is associated with an increased rate of caesarean deliveries, higher NICU admission rates, and significant neonatal complications. Early identification and prompt intrapartum management can enhance both maternal and neonatal outcomes.