Meconium aspiration syndrome and neonatal outcome: a hospital based study

Background: The incidence of meconium stained amniotic fluid is 8-20% among all deliveries. The Aspiration of meconium into the airway results in various short term and long term morbidities and mortality. Timely management of these neonates with meconium in amniotic fluid may prevent Meconium aspiration syndrome.Methods: This prospective cohort study was conducted at Kempegowda Institute of Medical Sciences, Bangalore. All live Term neonates born between December 2016 and July 2018 with meconium in amniotic fluid were enrolled in the study. Details of the neonate was entered in the pre-designed Proforma. The objective of this study the outcome of MAS neonates and find factors associated with Meconium aspiration syndrome when compared with Meconium stained amniotic fluid neonates as a whole. These associated factors were presented as Odds Ratio (OR) and 95% Confidence Interval. Chi-square test was done where applicable and a p-value <0.05 was taken as significant.Results: Meconium aspiration syndrome was seen in 79 out of the 188 neonates born with meconium stained amniotic fluid.Conclusions: The morbidity and mortality in a neonate with Meconium stained amniotic fluid (MSAF) to develop meconium aspiration syndrome (MAS) can be avoided with timely antenatal care. Meconium-stained babies should be aggressively managed to prevent complications like perinatal asphyxia and respiratory failure which may lead to the mortality. Those neonates with risk for adverse outcome should be managed with special focus on respiratory care with use of assisted ventilation and inhaled nitric oxide and extracorporeal membrane oxygenation, where available.

Meconium Stained Amniotic Fluid And Meconium Aspiration Syndrome: A Prospective Study.

Objectives:This study was to evaluate the incidence of meconium aspiration syndrome in babies born to mothers with meconium stained amniotic uid and were to determine the risk factors leading to MSAF, the signicance of blood levels of lactate in determining severity of MAS, determine immediate perinatal outcomes of babies with MSAF and MAS and to evaluated the mortality rate of babies that develop MAS. Methodology:Atotal of 75 babies born of mothers with MSAF were enrolled in this study. Detail assessment was taken to all babies. Gestational age was calculated as per Modied Ballard score. Blood sample was taken for blood lactate levels estimation and x ray were done. Other routine investigations were performed throughout NICU stay. Results: Data was analyzed by using IBM SPSS Statistics 24 model. Pearson chi-square test and Fisher exact tests were used to assess the association between attributes. Binary logistic regression analysis was used to assess the risk factors for MAS. P value was taken ≤ 0.05 for signicant differences. Conclusions: Incidence of MAS was 10.7% of MSAF babies. MSAF and MAS were more common in Babies of para 1 and para 2 mothers. Anaemia followed by pregnancy induced hypertension was common risk factors for MSAF and MAS. MAS was more common in male babies. Term babies and who were birth weight > 3000 grams were affected with MSAF and MAS. Majority of babies with MSAF had no asphyxia. Tachypnea and expiratory grunting were commonly seen in babies with MAS. Babies with MAS, the commonest radiological ndings were observed on the right side alone (50%), followed by bilateral changes (37.5%). Majorities of babies with MAS had blood lactate levels 7.5- 15mmol/l. Blood lactate levels in MSAF babies can predict the severity of MAS. Mortality rate of babies with MAS was 12.5%.