Meconium-stained amniotic fluid--perinatal outcome and obstetrical management in a low-risk suburban population.

Objective: To determine whether amniotic fluid (MSAF) affects obstetrical interventions and immediate perinatal outcome in a low-risk suburban population.

Study Design: A retrospective cohort study examined 11,226 deliveries at Tübingen University Hospital (1998-2003). Thousand one hundred and twenty-three women (10%) had MSAF during labor. A control group of matched pairs was created, assigning to each patient the next woman that gave birth without MSAF. Exclusion criteria were: gestational age less than 37+0 weeks, primary Cesarean (C-)section, multiple gestation, severe maternal disease, preeclampsia and fetal malformations.

Results: Only small differences were noted between the meconium and non-meconium groups with regard to arterial pH and Apgar scores: mean arterial-pH was 7.26 (+/-0.7) for both. Five minutes Apgar scores <6 occurred in 0.9% versus 0.4%. Obstetrical interventions were more common in the meconium group: C-section rates were 17.4% versus 9.6%, vaginal operative delivery rates 13.9% versus 6.2% and scalp pH rates 9.5% versus 3.7%, respectively.

Conclusions: In a low-risk suburban population the effect of MSAF on the newborn during the immediate postpartum period was small. However, obstetrical management was significantly effected by the presence of MSAF, possibly reflecting a combination of more difficult labor and a lower threshold for obstetric intervention.