Abstract
Objective: The goal of this study was to determine if meconium staining of the amniotic fluid (MSAF) is a marker for chorioamnionitis.
Methods: In a retrospective, case-control investigation, we studied 100 patients with MSAF. Each patient was matched with a control who delivered during the same period but did not have MSAF. Subjects and controls were matched for age, parity, gestational age, mode of delivery, duration of rupture of membranes (ROM), length of internal monitoring, and number of examinations before and after ROM. The incidence of chorioamnionitis in controls and study patients was compared. The diagnosis of chorioamnionitis was based on clinical examination.
Results: Thirteen of the 200 patients [6.5%, 95% confidence interval (CI), 2.5–10.5%] developed chorioamnionitis. Of the 100 women with MSAF, 10 (10%, 95% CI, 4–16) were infected compared with only 3 controls (3%, 95% CI, 0–6, P = 0.04). The odds ratio (OR) for this comparison was 3.3, and the 95% CI was 1.02–10.63.
Conclusions: MSAF is associated with an increased frequency of chorioamnionitis. Several factors could explain this association. Infection may cause fetal stress, leading to the release of meconium. MSAF may enhance the growth of bacteria by providing a rich medium of essential nutrients or growth stimulants. MSAF also may impair the host immune system so that chemotaxis or phagocytosis is diminished, thus allowing accelerated growth of microorganisms.
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Selected References
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- Blot P., Milliez J., Breart G., Vige P., Nessmann C., Onufryk J. P., Dendrinos S., Sureau C. Fetal tachycardia and meconium staining: a sign of fetal infection. Int J Gynaecol Obstet. 1983 Jun;21(3):189–194. doi: 10.1016/0020-7292(83)90078-4. [DOI] [PubMed] [Google Scholar]
- Florman A. L., Teubner D. Enhancement of bacterial growth in amniotic fluid by meconium. J Pediatr. 1969 Jan;74(1):111–114. doi: 10.1016/s0022-3476(69)80016-8. [DOI] [PubMed] [Google Scholar]
- Halliday H. L., Hirata T. Perinatal listeriosis--a review of twelve patients. Am J Obstet Gynecol. 1979 Feb 15;133(4):405–410. doi: 10.1016/0002-9378(79)90061-9. [DOI] [PubMed] [Google Scholar]
- Hoskins I. A., Hemming V. G., Johnson T. R., Winkel C. A. Effects of alterations of zinc-to-phosphorus ratios and meconium content on group B Streptococcus growth in human amniotic fluid in vitro. Am J Obstet Gynecol. 1987 Sep;157(3):770–773. doi: 10.1016/s0002-9378(87)80047-9. [DOI] [PubMed] [Google Scholar]
- Markovitch O., Mazor M., Shoham-Vardi I., Chaim W., Leiberman J. R., Glezerman M. Meconium stained amniotic fluid is associated with maternal infectious morbidity in pre term delivery. Acta Obstet Gynecol Scand. 1993 Oct;72(7):538–542. doi: 10.3109/00016349309058159. [DOI] [PubMed] [Google Scholar]
- Miller F. C., Sacks D. A., Yeh S. Y., Paul R. H., Schifrin B. S., Martin C. B., Jr, Hon E. H. Significance of meconium during labor. Am J Obstet Gynecol. 1975 Jul 1;122(5):573–580. doi: 10.1016/0002-9378(75)90052-6. [DOI] [PubMed] [Google Scholar]
- Newton E. R., Prihoda T. J., Gibbs R. S. Logistic regression analysis of risk factors for intra-amniotic infection. Obstet Gynecol. 1989 Apr;73(4):571–575. [PubMed] [Google Scholar]
- Romero R., Hanaoka S., Mazor M., Athanassiadis A. P., Callahan R., Hsu Y. C., Avila C., Nores J., Jimenez C. Meconium-stained amniotic fluid: a risk factor for microbial invasion of the amniotic cavity. Am J Obstet Gynecol. 1991 Mar;164(3):859–862. doi: 10.1016/0002-9378(91)90529-z. [DOI] [PubMed] [Google Scholar]
- Soper D. E., Mayhall C. G., Dalton H. P. Risk factors for intraamniotic infection: a prospective epidemiologic study. Am J Obstet Gynecol. 1989 Sep;161(3):562–568. doi: 10.1016/0002-9378(89)90356-6. [DOI] [PubMed] [Google Scholar]
- Wen T. S., Eriksen N. L., Blanco J. D., Graham J. M., Oshiro B. T., Prieto J. A. Association of clinical intra-amniotic infection and meconium. Am J Perinatol. 1993 Nov;10(6):438–440. doi: 10.1055/s-2007-994625. [DOI] [PubMed] [Google Scholar]
- Yancey M. K., Duff P., Clark P., Kurtzer T., Frentzen B. H., Kubilis P. Peripartum infection associated with vaginal group B streptococcal colonization. Obstet Gynecol. 1994 Nov;84(5):816–819. [PubMed] [Google Scholar]