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Meconium-stained liquor — DRCOG MCQ

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HardIntrapartum CareMeconium-stained liquorDRCOG

A 27-year-old woman at 40 weeks attends a midwife-led unit in spontaneous labour. On rupture of membranes there is thick meconium-stained liquor. Maternal observations are normal and fetal heart is 145 bpm on auscultation. What is the most appropriate management?

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Correct answer: A — Transfer to obstetric-led care for continuous fetal monitoring

Thick meconium is a risk factor requiring obstetric-led care and continuous fetal monitoring. It does not by itself mandate emergency caesarean when fetal status is reassuring. Antibiotics are not indicated solely for meconium-stained liquor. The pearl is that intrapartum risk status can change after membrane rupture.

Reference: NICE NG235