Maternal and Perinatal Outcomes in Childbirths with Meconium Stained Amniotic Fluid in a Low-resource Setting: A Prospective Cohort Study
Gregory E. Halle-Ekane *
Department of Obstetrics and Gynecology, Faculty of Health Sciences, University of Buea, Cameroon.
Phyllis N. Fon
Department of Internal Medicine and Pediatrics, Faculty of health Sciences, University of Buea, Cameroon.
Paul N. Koki
Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon.
Alexis A. Tazinya
Department of Internal Medicine and Pediatrics, Faculty of health Sciences, University of Buea, Cameroon.
Rodrigue Ekollo
Faculty of Health Sciences, University of Buea, Cameroon.
Emile Mboudou
Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, Yaoundé, Cameroon.
*Author to whom correspondence should be addressed.
Abstract
Meconium stained amniotic fluid (MSAF) can be associated with a high maternal and perinatal mortality. There is paucity of data on maternal and fetal outcomes of MSAF in Cameroon.
Aim: The study was to determine the maternal and perinatal outcomes in patients with MSAF.
Study Design: Prospective cohort study.
Place and Duration of Study: The study carried out in the Limbe Regional Hospital maternity, Cameroon from 10th January 2017 to 20th April 2017.
Methodology: Fifty- two mothers who had MSAF and their neonates, were matched with controls (without MSAF) in a 1:1 ratio after matching for: age, gestational age, parity and body mass index. Risk ratio (RR) of MSAF on the various perinatal outcomes were calculated by multivariate logistic regression with MSAF (-) being the reference. Data was analyzed with Epi Info 7.
Results: Two hundred and three deliveries were conducted during the study period with fifty-two with MSAF enrolled in the study. The proportion of participants with MSAF was 19.1%. Parturients who had thick MSAF were 3 times more likely to have caesarean sections (RR: 3.2, 95% CI= 1.1 - 10.2, p = 0.04). Two (3.9%) parturients with chorioamnionitis had MSAF. The neonatal complications were: non- reassuring fetal heart rate (RR=4.4, 95%CI: 1.1-16.8, p=0.02), neonatal sepsis (RR=3.7, 95%CI: 1.4-9.8, p=0.01) and neonatal intensive care unit admissions (RR=2.9, 95%CI: 1.2-6.9, p=0.02), were associated with MSAF. Two (3.9%) had meconium aspiration syndrome on clinical examination. No maternal death was recorded. However, a perinatal death occurred in a parturient with MSAF.
Conclusion: The proportion of parturients with MSAF was high. MSAF was associated with increased maternal and neonatal morbidity. We recommend larger and robust cohort studies to further refine our findings.
Keywords: Meconium stained, amniotic fluid, maternal and perinatal morbidity, mortality, Cameroon