Why meconium in amniotic fluid

In most cases, the outlook is excellent and there are no bad side effects. In more severe cases, breathing problems may occur, though they generally go away in two to four days. However, rapid breathing may persist for days. An infant with severe aspiration who requires a breathing machine may have a more guarded outcome.

Lack of oxygen in the uterus or from complications of meconium aspiration may lead to brain damage. Meconium aspiration rarely leads to permanent lung damage. Health Home Conditions and Diseases. Symptoms Bluish skin color in the infant Breathing problems Dark, greenish staining or streaking of the amniotic fluid or the obvious presence of meconium in the amniotic fluid Limpness in infant at birth Diagnosis Before birth, the fetal monitor may show a slow heart rate.

All women who gave birth at term in Felege Hiwot Referral hospital were the source population. This study included all women who gave birth at term throughout the day and night during the data collection period. Those mothers who presented with breech presentation and intrauterine fetal death before the onset of labor were excluded from the study.

The sample size was determined by taking predictors for MSAF from previous studies and by using Epi info software version 7. After enrolling different significant factors in the previous studies, cord problem was one of the factors which had a maximum number for our sample size [ 16 , 17 ].

Systematic random sampling was applied to identify study participants from postnatal and maternity ward. Totally women were delivered in two months; on average women were delivered per month. The data were collected within two-month duration. So as to find the sampling fraction, the total number of women who were delivered in two months was divided by the total number of sample size and it was approximately 3. The first woman was selected by lottery method then every 3rd woman who gave birth was recruited for the study.

Meconium stained amniotic fluid was defined as the presence of meconium in the amniotic fluid which changes the color of the liquor from clear to various shades of green, yellow or brownish color depending on the degree of meconium stained liquor. Data were collected using a combination of interview and chart review by three BSc midwives who were trained for this purpose. Structured interviewer-administered data collection formats were adopted and modified from different kinds of literature.

Questionnaires which guided chart review and interview were structured into four logical sections socio -demographic characteristics, obstetric related factors; medical history and Behavioral related factors. Data on patient specific socio- demographic, obstetric, medical and behavioral information were collected through interview of the mother and by reviewing her medical records. Socio-demographic, obstetric, medical and other factors were examined as a potential predictor in this analysis.

Socio-demographic factors include age, ethnicity, residency, religion, educational status, marital status and occupation. Obstetric related factors include parity, Rh status, the onset of labor, late-term pregnancy, premature rupture of membrane, prolonged premature rupture of membrane, preeclampsia, oligohydramnios, IUGR, antepartum hemorrhage, cord problem, chorioamnionitis, duration of labor, mode of delivery, antenatal care follow up. Medically related factors include diabetes mellitus, gestational diabetes mellitus, anemia, hypothyroidism, hepatitis virus, chronic hypertension, asthma, jaundice, and cardiac disease.

Behavioral factors include Cigarette smoking, Cocaine use, marijuana addict and chat chewing. Data were entered into EPI data version 3. Descriptive statistics like frequencies and cross tabulations were performed. The mean age of the study participants was Nearly two third, The mean gestational age and duration of labor were Half of, The majority Concerning medical conditions of mothers, seven 1.

The prevalence of meconium stained amniotic fluid was found to be 88 Out of 88 cases delivered with MSAF, 35 The association between socio-demographic, obstetrical, medical conditions of women, and MSAF were assessed. In the bivariate analysis; maternal age, marital status, Rh status, duration of labor, gestational age, the onset of labor, IUGR, preeclampsia and obstructed labor became significant at 0.

However, maternal age, the onset of labor, preeclampsia, duration of labor and obstructed labor were remained significantly and independently associated with MSAF in the multivariable analysis. Mothers whose age greater than 30 years were 5.

Women who had induced labor were 2. Mothers who had preeclampsia were 3. The chance of developing MSAF in obstructed labor was 5. The prevalence of meconium stained amniotic fluid was This finding was in line with the finding from Jimma University specialized hospital This might be due to the similarity in socio-demography, health institution and quality of service they provided.

This finding was also in line with the finding from the Nigerian University Teaching Hospital This might be due to the similarity in accessibility and quality of services. However, this finding was higher than the study finding in Southeastern Brazil This discrepancy might be due to the difference between the accessibility and the quality of services in study settings.

In addition to this, this study was done in a tertiary referral hospital which covers a wide catchment area and most of the patients referred to this hospital were already complicated and might have predisposing factors for MSAF. The difference could be attributed to the time gap between the studies.

An additional explanation could be due to the emphasis is given by the Ethiopian government on maternal and child health services in the last years to improving maternal health services program. In addition to this, low behavioral risk factors for MSAF such as smoking, Cocaine use, and Marijuana addict were not found in this study area.

Age of the women was significantly associated with the development of MSAF. This finding was consistent with study findings in Indira Gandhi Medical College [ 22 ]. This could be explained as a woman gets older, she is more likely to have a gradual loss of compliance of the cardiovascular vessels that is mainly associated with aging of uterine blood vessels and arterial stiffness which may result in insufficient placental perfusion and in utero fetal hypoxia.

This finally leads to passage of meconium into the amniotic fluid. This study also indicated that a significant association was noted between induced labor and MSAF. This might be related to tetanic uterine contraction uterine tachysystole following oxytocin administration, which may result in intrauterine fetal hypoxia secondary to inadequate placental perfusion. When the fetus suffers from hypoxia or asphyxia, increased parasympathetic stimulation by vagus leads to passage of meconium.

In this study, longer duration of labor showed a statistically significant association with meconium-stained amniotic fluid. This could be due to a prolonged stressful environment for the fetus, which may result in increased peristalsis of a fetal gastrointestinal tract and relaxation of anal sphincter then the passage of meconium.

Preeclampsia had a statistically significant association with the development of MSAF. The reason might be explained by the possibility of placental insufficiency in preeclampsia that leads to intrauterine fetal hypoxia or intestinal ischemia.

This intrauterine hypoxia finally weakens the action of rectal sphincters and leading to the passage of meconium. In this study, obstructed labor had a statistically significant association with the development of meconium-stained amniotic fluid. The finding was in agreement with the study conducted in the Nigerian University Teaching Hospital [ 18 ].

The reason might be due to the possibility of maternal dehydration, maternal distress and shock, which may result in intrauterine fetal hypoxia secondary to insufficient placental perfusion then the passage of meconium into the amniotic fluid. This study shares the limitations of cross-sectional studies and hence may not be possible to establish a temporal relationship between MSAF and explanatory variables. Besides, as the study was conducted in a single referral hospital, the results might not be representative of other institutions and the community.

Another limitation is possible to recall bias while determining the gestational age. The prevalence of meconium stained amniotic fluid was similar compared to the international standard. Multifaceted factors such as preeclampsia, maternal age greater than 30 years, obstructed labor, induced labor and longer duration of labor were independently associated with an increased risk for meconium-stained amniotic fluid in term pregnancies.

Hence, early detection by using a latent follow-up chart and partograph and timely intervention is recommended to decrease prolonged and obstructed labor. We also recommend using induction protocols strictly in a woman who is on induction to prevent uterine tachysystole.

Fetal outcome in deliveries with meconium stained liquor. Bangladesh J Child Health. The infant may be placed in the special care nursery or newborn intensive care unit in order to be watched closely. Other treatments may include: Antibiotics to treat possible infection. Breathing machine ventilator if baby is unable to breathe on their own or needs a large amount of extra oxygen. Oxygen to keep blood levels normal. Intravenous IV nutrition -- nutrition through the veins -- if breathing problems are keeping baby from being able to feed by mouth.

Radiant warmer to maintain body temperature. Surfactant to help lungs exchange oxygen. This is only used in more severe cases. Nitric oxide also referred to as NO, an inhaled gas to help blood flow and oxygen exchange in the lungs. This is only used in severe cases. It may be used in very severe cases. Outlook Prognosis. Babies may need extra support with breathing and nutrition in some cases. This need will often go away in 2 to 4 days. However, rapid breathing may continue for several days.

MAS rarely leads to permanent lung damage. Your provider will want to be prepared for meconium being present at birth if: Your water broke at home and the fluid was clear or stained with a greenish or brown substance. Any testing done during your pregnancy indicates there may be problems present. Fetal monitoring shows any signs of fetal distress. Alternative Names. Childbirth Problems Read more. Lung Diseases Read more.