Relationship between umbilical cord arterial blood pH and meconium-stained liquor

Intrauterine passage of meconium may emerge due to fetal hypoxia or may merely indicate a normal gastrointestinal tract maturation. Umbilical cord blood pH is the best available criterion for detecting fetal hypoxia and constructing appropriate judgments about care after birth.

Kima V et al. determined the correlation of umbilical cord arterial blood pH with meconium-stained liquor and neonatal outcome. They also determined whether the mode of delivery influences the occurrence of acidemia in the neonate complicated with meconium-stained liquor.

They conducted a prospective observational study for six months, during which they drew blood from the umbilical artery and sent it for arterial blood gas (ABG) analysis immediately following delivery in pregnancies complicated with meconium-stained liquor. They also recorded Neonatal outcome parameters and mode of delivery in a pre-designed proforma.

The researchers found a significant correlation between abnormal pH (acidosis) and thick meconium-stained liquor. Neonatal outcome parameters like Apgar scores at 1 minute and 5 minutes, intravenous antibiotic administration, NICU admission, and oxygen supplementation were significant when correlated with the pH level.

Thus it is confirmed that the degree of meconium thickness links with the composite adverse neonatal outcome. It is crucial to vigorously monitor cases with meconium-stained liquor with timely interventions and proper neonatal resuscitation, especially those with thick meconium-stained liquor, to prevent adverse neonatal outcomes.

Kima V, Roy I, Saikia N. Correlation of umbilical cord arterial blood pH with meconium stained liquor. Indian J Obstet Gynecol Res 2023;10(1):27-31