A G4P2 client at 38 weeks presents with a small amount of watery, green vaginal discharge for about an hour and contractions for 3 hours. Fetal heart rate is 128/min with moderate variability; cervix is 5 cm dilated, 80% effaced, and +1 vertex; watery green vaginal fluid with no odor; SROM confirmed by tests. What is the most likely description of the amniotic fluid?

• A. Meconium-Stained Amniotic Fluid
• B. Clear Amniotic Fluid
• C. Foul-smelling Amniotic Fluid
• D. Bloody Amniotic Fluid

Answer: (A)

Green-tinged amniotic fluid indicates that meconium has been released into the amniotic sac. In this scenario, spontaneous membrane rupture with a watery, green discharge and no odor points to meconium-stained amniotic fluid. Meconium is the fetus’s first stool; it can be passed in utero and mix with the amniotic fluid, producing a green color. The lack of odor helps distinguish it from infection, which would more likely present with foul-smelling fluid or other signs of chorioamnionitis. Clear amniotic fluid would be normal, foul-smelling would suggest infection, and bloody would imply placental abruption or trauma. Therefore, the description most consistent with the situation is meconium-stained amniotic fluid.