North American Registry of Midwives (NARM) Practice Exam

Meconium stained amniotic fluid in the absence of other clinical signs of distress indicates which of the following?

1. Potential fetal distress

2. Fetal well-being

3. Not a sign of fetal distress

4. Immediate intervention required

The correct answer is: Not a sign of fetal distress

Meconium-stained amniotic fluid can occur in a variety of situations during labor. When it appears in the absence of other clinical signs of fetal distress, it is not inherently indicative of a problem. Many infants pass meconium into the amniotic fluid while still in the womb simply as a result of normal physiological processes, particularly when they are postterm or if the pregnancy is prolonged. This can be considered a normal variant, especially if the fetus continues to show reassuring signs, such as a stable heart rate and good muscle tone. In such cases, the presence of meconium alone is not sufficient to conclude that there is an immediate risk to the fetus. Therefore, meconium-stained amniotic fluid without other distress signals is interpreted as a non-significant finding that does not require immediate intervention. Close monitoring may still be warranted, but the absence of other distress indicators allows for a more measured approach rather than panic or aggressive intervention, highlighting the importance of context in clinical assessments.