Incidental finding of meconium-stained amniotic fluid in elective cesarean deliveries: Features and perils

Objective To characterize pregnancies in which meconium-stained amniotic fluid (MSAF) was incidentally discovered during elective caesarean delivery (CD), and to evaluate the association with adverse neonatal outcomes. Methods A retrospective study was performed on all patients who underwent elective CD with singleton pregnancies between March 2011 and June 2020. Data analyzed included maternal, pregnancy, and neonatal characteristics. A comparison was made between pregnancies with clear amniotic fluid, MSAF, and thick MSAF. Results During the study period, 10 445 patients with singleton pregnancies underwent elective CD. Of them, 368 (3.5%) had MSAF and 31 (0.3%) had thick MSAF. Patients with MSAF gained more weight during pregnancy and suffered more from diabetes compared with patients with clear fluid. Significantly more pregnancies with MSAF had either oligohydramnios or polyhydramnios. Pregnancies in the thick-MSAF group had more intrahepatic cholestasis of pregnancy. No differences were found between the groups in the composite adverse neonatal outcome, including 5-min Apgar score, need for mechanical ventilation, and admission to the neonatal intensive care unit. Conclusion The incidental finding of MSAF during elective CD is not associated with increased risks of adverse neonatal outcomes.