A STUDY ON PREVALENCE OF MECONIUM-STAINED LIQUOR IN SINGLETON TERM PREGNANCY IN A TERTIARY CARE HOSPITAL

Abstract

Background: Meconium-stained liquor (MSL) is a common intrapartum finding in term pregnancies and is considered an important indicator of potential fetal compromise. Although meconium passage may occur as a physiological phenomenon in advanced gestation, thick meconium is associated with increased maternal intervention and adverse neonatal outcomes. Evaluating its prevalence and associated risk factors is essential for optimizing obstetric and neonatal care. Materials and Methods: This hospital-based cross-sectional observational study was conducted in the Department of Obstetrics and Gynaecology at a tertiary care teaching hospital over 18 months. A total of 1,702 singleton term deliveries were screened, among which 312 women with meconium-stained liquor were included. Maternal demographic characteristics, obstetric variables, medical comorbidities, mode of delivery, and neonatal outcomes were recorded. Meconium-stained liquor was graded into Grade I, Grade II, and Grade III based on gross visual appearance. Statistical analysis was performed using SPSS version 21. Associations between categorical variables were analysed using the Chi square test or Fisher's exact test, with p <0.05 considered statistically significant. Results:The prevalence of meconium-stained liquor was 18.33%. Grade I, Grade II, and Grade III meconium accounted for 48.39%, 32.37%, and 19.23% of cases, respectively. Most women were aged 26–30 years (40.1%), 58.0% were primigravida, and 77.6% underwent labour induction. Maternal comorbidities, including gestational diabetes mellitus (16.0%), gestational hypertension (11.9%), preeclampsia (9.9%), and hypothyroidism (14.1%), were significantly more common among women with MSL (p<0.05). Emergency lower segment caesarean section was performed in 58.0% of cases. Neonatal outcomes showed 32.1% low Apgar scores, 35.5% NICU admissions, 24.0% meconium aspiration syndrome, and 0.3% neonatal mortality. Increasing grades of meconium were significantly associated with higher rates of NICU admission, meconium aspiration syndrome, and low Apgar scores (p<0.001). Conclusion: Meconium-stained liquor is a relatively common intrapartum finding associated with increased neonatal morbidity, particularly in cases of thick meconium. Maternal metabolic and hypertensive disorders, labour induction, and higher meconium grades were associated with adverse perinatal outcomes. Meconium-stained liquor should not be interpreted in isolation but should be assessed in conjunction with fetal heart rate monitoring and overall maternal–fetal status. Early identification of maternal risk factors, standardized intrapartum surveillance, and timely neonatal intervention are essential to improve perinatal outcomes.