4 Assessing the fetal condition during labour

25. How do you assess the condition of the fetus during labour?

Two observations are used:

1. The presence or absence of meconium in the amniotic fluid
2. The fetal heart rate pattern

When assessing the condition of the fetus during labour, it is much better to observe the fetal heart rate pattern than to only examine the amniotic fluid for meconium.

26. What is the importance of meconium-stained amniotic fluid?

Normally the amniotic fluid is clear and colourless. However, in 10–20% of labours the amniotic fluid is yellow or green due to meconium staining. Meconium-stained amniotic fluid usually indicates the presence of fetal hypoxia or an episode of fetal hypoxia in the past. Therefore, fetal distress may be present. If not, the fetus is at high risk of distress. It is essential to monitor the fetal heart rate very carefully if the amniotic fluid is meconium stained.

There is also a danger of meconium aspiration by the infant at delivery. The management of both mother and infant with meconium-stained amniotic fluid does not depend on the consistency of the meconium.

Meconium-stained amniotic fluid warns that there is a high risk of fetal distress.