Etiological factors, clinical profile and outcome of meconium aspiration syndrome babies

Background: Meconium staining of amniotic fluid has for long been considered to be a bad predictor of the fetal outcome because of its direct correlation of fetal distress, and increased the likelihood of inhalation of meconium, resultant deleterious effects on the neonatal lung. To evaluate etiological factors and severity of MAS in the study group.Methods: This study was done in the Neonatal intensive care unit of the Department of Paediatrics, Government Mohan Kumaramangalam Medical College Hospital Salem, Tamil Nadu, India in the year 2018. Complete maternal and neonatal details were recorded in to the proforma. Delivery details, resuscitation did were also recorded.Results: In present study, fetal distress was found to be the most common (42.5%) factor associated with MAS followed by PIH (21.6%) and PROM (17%). 22 (9.1%) cases were associated with Postdatism, 18 (7.5%) cases were associated with placental insufficiency. 88 babies had fetal distress (36.6%) prior to delivery. 138 babies had no fetal distress (57.5%).Conclusions: MAS is known to cause severe respiratory distress and Downe's score ranging between 4-8, usually a few hours after the onset of respiratory distress. Nearly 73.3% of the cases with MAS had birth asphyxia, out of which 30% had severe birth asphyxia. This indicates that passage of meconium can occur in utero, often considered a feature of the stressed fetus. Undoubtedly aspiration had occurred before delivery in these babies.

Etiological factors and clinical profile of acute respiratory distress in children age group 2 months to 2 years and prevalence of respiratory syncytial virus in the study population

Background: Acute lower respiratory tract infections are a common cause of morbidity and mortality in children. Respiratory infections in infants and small children are of great importance because of small airways. Infection may cause a further narrowing and may lead to respiratory distress. To evaluate the etiological factors, clinical profile and outcome of acute respiratory distress in the age group 2 months to 2 years.Methods: This study was conducted in the Paediatric department of Government Mohan Kumarmangalam medical college hospital, Salem, Tamil Nadu, India in the year September 2017-March 2018. Totally 183 cases of acute respiratory distress children were included in the study. A thorough clinical examination was done at the time of admission and management details were recorded into the proforma. Respiratory distress is defined as per WHO protocol as respiratory rate more than 50/minute in infants from 2 months to 12 months of age, and more than 40/minute in children from 13 months to 24 months of age.Results: Of the 72 cases of bronchiolitis, 32 cases (44%) tested positive for IgM at the time of admission and no cases in the control population tested positive for IgM. Of the 72 cases of bronchiolitis in the study population, 52 cases (72%) tested positive for ELISA IgG at the time of admission and 2 cases among the controls tested positive for ELISA IgG.Conclusions: Pneumonia was the most common cause of respiratory illness in the study population. Overcrowding was the major risk factor contributing to acute respiratory illness. Incidence of acute respiratory distress was high among undernourished children.