What is the significance of meconeum staining of the amniotic fluid in labour in
cases of prolonged pregnancy?
Passage of meconeum (baby ‘poo’) in the uterus for babies, who have stayed beyond
term is a common occurrence. It is therefore, never surprising to see stained fluid
(at this juncture called ‘liquor’) on breaking the waters.
However, if the meconeum appears fresh and thick, it may be a sign of distress on
the part of the baby. This should trigger immediate electronic fetal monitoring.
If the cardiotocograph (CTG) shows suspicious features at an early stage of labour,
a caesarean delivery will most likely be resorted to.
The passage of fresh thick meconeum before or at the onset of labour, signalling
distress, is not the preserve of post-term pregnancy. It is also seen in labour occurring
at term or occasionally preterm.
Is labour after prolonged pregnancy likely to be more difficult?
There is no evidence to this effect. Delivery is probably marginally more difficult
because, on average, these babies tend to be bigger.
What is amnio-infusion?
This is mentioned here for completion's sake. This is a practice where sterile fluid
- usually warm saline - is infused into the uterine cavity using a catheter. The
aim is to counter the effect of severely reduced amniotic fluid and reduce such occurrences
as cord compression. Where this has been used, results have been reported as encouraging.
However, it is by no means mainstream obstetrics and, at this juncture remains experimental.