The fetal and newborn benefits of delivery, rather than expectant management, at term include: a decrease in stillbirth and perinatal death rates, a decrease in admissions to the neonatal intensive care unit (NICU), a decrease in meconium-stained amniotic fluid
and meconium aspiration syndrome, a decrease in low Apgar scores, and a decrease in problems related to uteroplacental insufficiency, including oligohydramnios.
The rate of meconium-stained amniotic fluid
varies from 12 to 20%.10 It is higher in underdeveloped countries.
Antibiotics for meconium-stained amniotic fluid
in labour for preventing maternal and neonatal infections.
Many parameters are used to predict perinatal asphyxia, namely--intrapartum electronic foetal monitoring, foetal or umbilical cord pH measurement, meconium-stained amniotic fluid
(MSAF), APGAR score, hypoxic-ischaemic encephalopathy (HIE) and evidence of multiorgan dysfunction.7 Umbilical cord blood gas analysis is now recommended in all high-risk deliveries by both the British and American College of Obstetricians and Gynaecologists.
* Meconium-stained amniotic fluid
(MSAF): 17-fold greater odds.
(1, 2) The time interval from the first dose of misoprostol to delivery, number of misoprostol doses, uterine hyperstimulation, need for oxytocin augmentation, meconium-stained amniotic fluid
, method of delivery, indications for abdominal delivery, neonatal birth weight, Apgar score and cord blood gas analysis, neonatal intensive care unit (NICU) admission, and outcome were compared between the 2 groups.
(2-7) Guidelines from the Neonatal Resuscitation Program (NRP) and other organizations recommend against the practice, even for neonates born through meconium-stained amniotic fluid
. (8, 9) Suctioning is done because some clinicians believe it reduces the risk of aspiration, especially if there is meconium, and to stimulate breathing, but the evidence suggests that suctioning can stimulate the vagus nerve, which can lead to bradycardia.
Kulaylat, "Is gastric lavage needed in neonates with meconium-stained amniotic fluid
?" European Journal of Pediatrics, vol.
While an observational study of this type cannot assume causality, it is an interesting association that was noted between cases of MAS and meconium-stained amniotic fluid
and the source of the drinking water.
-- Saline amnioinfusion for labors with thickly meconium-stained amniotic fluid
does not prevent meconium aspiration syndrome, William D.
In a study of women with meconium-stained amniotic fluid
and no signs of clinical infection, randomization to treatment with antibiotics resulted in a significant decrease in the intraamniotic infection rate.
A high prevalence of meconium-stained amniotic fluid
is an outstanding feature among the intrapartum and asphyxial neonatal deaths.