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Correlation of Meconium-Stained Amniotic Fluid and Adverse Pregnancy Outcomes between 37 to 39 and 40 to 42 Weeks of Gestational Age

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Abstract Objective  We aimed at assessing the association between meconium-stained amniotic fluid (MSAF) and adverse maternal and neonatal outcomes in early-term versus late-term pregnancies. Study Design  Early-term pregnancies (37–39 weeks… Click to show full abstract

Abstract Objective  We aimed at assessing the association between meconium-stained amniotic fluid (MSAF) and adverse maternal and neonatal outcomes in early-term versus late-term pregnancies. Study Design  Early-term pregnancies (37–39 weeks of gestation) presented with MSAF were compared with late-term (40–42 weeks of gestation) pregnancies with MSAF. The groups were compared with respect to background characteristics, maternal outcomes, and neonatal outcomes. The composite neonatal outcome was the primary outcome of the study, and secondary outcomes included maternal and neonatal outcomes. Results  The early-term group comprised 239 women, compared with 362 women in the late-term group. The primary outcome did not differ between groups. We found a higher prevalence of gestational diabetes (8.37 vs. 3%, p  < 0.05), a shorter second stage of labor (45.61 ± 54.67 vs. 65.82 ± 62.99 minutes, p  < 0.05), and a longer hospital stay (2.84 ± 2.21 vs. 2.53 ± 1.26 days, p  < 0.05) in the early-term group. Other maternal and neonatal characteristics and outcomes were not significantly different between the two groups. Conclusion  In term pregnancies complicated by MSAF, adverse neonatal and maternal delivery outcomes are equivalent, regardless of gestational age, and therefore, any term pregnancy complicated by MSAF should be considered high risk and managed appropriately. Key Points In term pregnancies complicated by MSAF, adverse neonatal and maternal delivery outcomes are equivalent, regardless of gestational age. Any term pregnancy complicated by MSAF should be considered high risk and managed appropriately. Deliveries presented with MSAF are typically considered to be high risk and require close fetal surveillance by a certified team with resuscitation skills. Our study may help to reduce the need for a close fetal surveillance and delivery interventions if MSAF is not identified as a risk factor for adverse outcomes in late-term pregnancies.

Keywords: term pregnancies; gestational age; term; meconium stained; pregnancy

Journal Title: American Journal of Perinatology
Year Published: 2022

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