Meconium Stained Liquor

Question 1

What is meconium?

Answer 1

Essentially fetal poo contains water, bile pigments, mucus and amniotic fluid.

It is a tarr coloured liquid.

Question 2

When are you more likely to see meconium stained liquor?

Answer 2

Later gestations (indicates maturation of GI and CNS)

Fetal distress (hypoxia causes temporary bowel and anal sphincter paralysis)

Question 3

What is the major worry about meconium stained liquor?

Answer 3

Meconium aspiration syndrome.

Aspiration of meconium can cause blockages and alveolar collapse also predisposes to infection.

Question 4

How is meconium stained liquor managed?

Answer 4

If grade 3

Continuous CTG monitoring

If signs of distress on CTG do fetal blood sampling

Aim to deliver ASAP
Induce or C section depending on FBS results

Ensure neonatal resus team are available

Post natal:
Suction if APGAR less than 5
Prophylactic abx
Ventilate if necessary

Question 5

What is grade 3 meconium?

Answer 5

Thick opaque meconium (pea soup)