Perinatal Outcome in Term Pregnancies with Meconium Stained Amniotic Fluid in Two Referral Hospitals of Yaoundé- Cameroon

Edmond Nzene Mesumbe¹*, Philip Njotang Nana^1,2, Julienne Stéphanie Nouetchognou³, Julius Sama Dohbit⁴, Evelyn Mah⁴, Flibert Eko Eko², Jeanne Fouedjo² and Agnes Essiene²

Received: January 25, 2018;   Published: February 07, 2018

DOI: 10.26717/BJSTR.2018.02.000736

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Abstract

Background: Meconium stained amniotic fluid (MSAF) is frequent in obstetric and neonatal practice. It is responsible for maternal, foetal and neonatal complications. The objective of this study was to determine the association of MSAF with perinatal outcome.

Methods: This was a prospective cohort study targeting pregnant women admitted in the labour wards of the maternity services of the Yaoundé Central Hospital (YCH) and the Gynaeco-Obstetric and Paediatric Hospital of Yaoundé (GOPHY). It was conducted during a 5 month period, from 1st December 2014 to 30thApril 2015. A total of 426 Women with singleton deliveries at term with cephalic presentation were included in the study. They were classified in exposed, for those with MSAF and non-exposed, for those with clear amniotic fluid (CAF). The two groups were followed up during labour and 72 hours following delivery. Mode of delivery, foetal heart rate, Apgar score at the 1st and 5th minute, the unset of meconium aspiration syndrome and neonatal death were recorded.

Results: The incidence of MSAF was 11.15%, of which 52.1% was thick meconium stained. Maternal morbidity was high in the MSAF group with higher proportions of caesarean delivery (RR=2.35 p<0.001). Foetuses and neonates born with MSAF had higher morbidity and mortality when compared to those with CAF. Complications included foetal heart rate abnormalities, low Apgar score at the 1st and 5th minute, need for neonatal resuscitation and neonatal asphyxia. Perinatal mortality was 4.7% in the MSAF group and 00% in CAF. All cases of death (10) were seen in the thick MSAF group.

Conclusion: MSAF is associated to increased perinatal morbidity and mortality. Caesarean sections were performed twice as frequently in women presenting with MSAF.

Keywords: Meconium stained amniotic fluid; Perinatal outcome; Yaoundé; Cameroon

Abbreviations: MSAF: Meconium Stained Amniotic Fluid; MAS: Meconium Aspiration Syndrome; CAF: Clear Amniotic Fluid; YCH: Yaoundé Central Hospital; GOPHY: Gynaeco-Obstetric and Paediatric Hospital of Yaoundé; USA: United States of America; CTG: Cardio Topography; FHR: Foetal Heart Rate

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