Meconium staining of amniotic fluid and its associated perinatal outcomes at Harare Central and Mbuya Nehanda Maternity Hospitals, Zimbabwe

Abstract

Objectives: To determine the prevalence of meconium staining of amniotic fluid and perinatal morbidity and mortality in pregnancies complicated by meconium staining of liquor at Harare Central and Mbuya Nehanda Maternity Hospitals.

Design: A cross sectional study.

Setting: The study was conducted at Mbuya Nehanda and the Harare Central Maternity Hospitals.

Subjects: Women with meconium staining of amniotic fluid observed during labour.

Main Outcome Measures: The outcomes measured were prevalence of meconium staining of amniotic fluid, mode of delivery and the perinatal outcomes.

Results: The prevalence of meconium staining of amniotic fluid was 19% at the Harare Central Hospital (HCH) Maternity unit. It was associated with higher rates of caesarean delivery (p=0.019). Longer exposure to meconium was associated with lower 5 minute Apgar scores. Perinatal mortality was 4.7% in the study. Most deaths were in the thick meconium group (p=0.025). Meconium aspiration syndrome occurred in 31% of babies. Forty seven percent (47%) of babies in the study were admitted to nursery with 72% of them being diagnosed of meconium aspiration syndrome.

Conclusion: The prevalence of Meconium Stained Amniotic Fluid (MSAF) was 19%. Meconium stained amniotic fluid was associated with increased adverse perinatal outcomes like meconium aspiration syndrome, admission to nursery and perinatal mortality. It was also associated with increased caesarean section rate. Mode of delivery did not have a statistically significant effect on perinatal outcomes.