Should fetal scalp blood sampling be performed in the case of meconium-stained amniotic fluid?

OBJECTIVE: To investigate the effect of using fetal scalp blood sampling on the risk of neonatal respiratory distress syndrome (NRDS) with meconium-stained amniotic fluid (MSAF).

METHODS: Prospective data collection with regard to MSAF during labor for low-risk term cephalic singleton live birth from 2012 to 2014. Maternal, obstetric and neonatal data were compared according to the occurrence of respiratory distress syndrome (RDS group) or not (no RDS group).

RESULTS: Of 515 newborns born through MSAF, 46 experienced RDS and from them 10 experienced meconium aspiration syndrome. No difference was observed according to maternal characteristic, abnormal fetal heart rate tracing pattern irrespective of its category and cesarean rate. Apgar at one minute was lower in the group RDS (7.6 versus 8.5, p < 0.05). The mean umbilical artery pH values did not differ between the two groups. Significant difference between newborns with and without RDS in terms of fetal scalp lactate sampling during the labor (71.1% versus 55.1%, p < 0.05), and neonatal care unit (NCU) admissions (22.8% versus 10.8%, p < 0.05). Secondary rather than primary meconium was associated with RDS when performing fetal scalp blood assessment (p < 0.05). A significant correlation between RDS, fetal scalp blood assessment and MSAF diagnosed during the first stage of labor (after spontaneous rupture of membranes or at amniotomy) was found.

CONCLUSION: In case of MSAF, fetal scalp blood sampling did not reduce the risk of RDS.