Identification and Management in Labor with Meconium Stained

Amniotic Fluid
1. Pre labor ruptured of membrane
 Any woman that makes contact
with the maternity service and
reports spontaneous rupture of
membranes with any meconium
staining should be advised
admission to the consultant led
unit for assessment.
 If MSL is confirmed, continuous
electronic fetal monitoring
(CEFM) should be commenced
and a plan made for induction of
labor (IOL).
2. Low risk intrapartum women in the community

 If during labor, MSL becomes evident, a risk assessment should

be undertaken to include, the stage of labor and parity

 whether the meconium staining is significant (significant is described

as either dark green or black meconium fluid that thick or tenacious or
contains lumps of meconium) or light

 Current wellbeing and transfer time.

 If transfer to a unit with neonatal facilities can be achieved before

delivery, the woman should be advised to transfer by ambulance to a
consultant led unit.

If birth is expected before transfer can be facilitated, preparations

should be made for resuscitation of the newborn and consideration
given to calling an ambulance for transfer of the baby following birth.
3. Intrapartum women in the consultant lead unit

 If woman is being cared for as low risk woman on delivery suite

and MSL is identified, the woman should be informed of the
significance of MSL and

 CEFM is indicated and that the presence of a member of

neonatal team will be called for delivery and observation of the
baby will be advised in the postnatal period.

 The patient data screen should be updated and the coordinator

and obstetrician informed of the presence of meconium and
care transferred to consultant lead care.
4. High risk intrapartum woman on delivery suite

 If the woman already has risks factors requiring CEFM and MSL is
identified, the patient data should be updated and the coordinator
and obstetrician should be informed of the presence of MSL, the
woman should be informed of the significance of MSL and that a
member of the neonatal team will be called for delivery and
observation of the baby will be advised in the post-natal period.