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incidence of neonatal intensive care admission, and a high perinatal death rate [3].Meconium passage is rare before 34 weeks of gestations, and after 37 weeks, its incidence increases steadily with increasing AbstractObjectives: This study evaluates the risk factors associated with meconium-stained amniotic fluid in neonates managed in the special care baby unit of Dhaka Medical College Hospital (DMCH). Methods:This case-control study was performed in DMCH from 1st March to 31st December 2011. One hundred fifty-two neonates were selected purposively. Seventy-six cases with meconium staining at birth formed the case group, and other seventy-six cases without meconium staining formed the control group. For both the case and control groups, information about the duration of labour, mode of delivery, maternal illness, and maternal medication during pregnancy were recorded. Any other complications like obstructed labour, history of premature rupture of membrane (PROM), and history of less fetal movement were taken from parents and available medical records. This data was then processed and analyzed using SPSS (version 24) to identify the newborn's risk factors associated with meconium staining. The odds ratio was calculated to identify the risk factors of meconium staining. Parents and guardians of the enrolled neonates were informed about the study, and written consent was obtained. The Ethical Review Committee of Dhaka Medical College Hospital approved this study.Results: Among the 152 neonates, all the 76 neonates of the case group had meconium staining at birth, and the rest 76 neonates of the control group did not have meconium staining. In the case group, 17.1% neonates had only staining, 73.7% neonates had ingestion, and 9.2% neonates had features of aspiration. 65.8% of study patients of the case group had fetal distress at birth, whereas only 3.9% of the control group had fetal distress. Out of the total 152 neonates, only 18 had gestational age more than 42 weeks, of which 13 neonates had meconium staining at birth. Delivery mode lower uterine Caesarean section (LUCS) was more common in the case (77.6%) group than the control (46.1%) group. In the case group, 86.8% of neonates had a prolonged duration of labour. Obstructed labour, presence of PROM, maternal illness, and maternal age had no statistically significant association with meconium staining. 99 out of 152 neonates required hospitalization for 72 -96 hours. Only 8 cases had expired; among them, 5 cases had ingestion and 3 cases had aspiration. Conclusion:This study found that fetal distress, gestational age of baby, delivery by LUCS, and prolonged duration of labour were significant risk factors of meconium staining at birth.

The aim of this study is to evaluate the growth failure in children with Congenital Heart Diseases (CHD) associated with the Pulmonary Hypertension (PH) and cyanosis. Growth parameters including weight, height and head circumference of 120 cases with congenital heart defects aged 6 months to 14 years were compared with standard growth curves (50th percentile) between November 2007 and November, 2008. Of all, sixty five (54.1%) were male and 55 (45.8%) were female. The patients were classified into four groups based on the presence or absence of PH and cyanosis. The gap between chronological age and bone age (BA) for all subjects was determined. Growth disturbance in weight, height and head circumference was detected in 80 (66.7%), 79 (65.8%) and 41 (34.2%) of the patients, respectively. Bone age delay was seen in fifty five percent of the cases. Generally, delay in all parameters was more seen in acyanotic patients with pulmonary hypertension. In subjects with cyanosis whether in addition to PH or not, bone age was significantly retarded. Etiology of growth failure in children with CHD is multifactorial. Further studies are required to assess the role of different factors in this field.

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