Meconium-Stained Amniotic Fluid and Meconium Aspiration Syndrome- A Study on Risk Factors and Neonatal Outcome

Abstract

BACKGROUNDMeconium is the first faeces of a newborn. Meconium-stained amniotic fluid (MSAF) occurs in about 7-22% of live births and is regarded as a sign of foetal compromise. Meconium aspiration syndrome (MAS) is a serious and potentially preventable condition with risk factors like post-dated pregnancy, small for gestational age, oligohydramnios, hypertensive disorder of pregnancy, gestational diabetes, and maternal drug abuse. Hence, the present study was conducted to find out the rate of MAS, analyse associated maternal and neonatal risk factors and final outcome in babies born through MSAF in a tertiary health care facility. Objectives-1. To find out the rate of Meconium aspiration syndrome (MAS) in babies born with Meconium-stained amniotic fluid (MSAF) in a tertiary health care facility, GGH, Guntur. 2. To analyse the associated maternal and neonatal risk factors associated with Meconium aspiration syndrome (MAS). 3. To evaluate the outcome of Meconium aspiration syndrome (MAS). MATERIALS AND METHODSA prospective, hospital based, observational study was carried out among 160 babies born with MSAF admitted to the NICU in a tertiary health care setting in the Department of Paediatrics, during a period of 5 months. Patient details were recorded in a predesigned semi-structured proforma. Informed written consent was taken from parents of babies. MAS was designated in a baby as per the defined criteria. Their risk factors and outcomes were analysed by using SPSS Software 18 version. Institutional ethics committee approval was obtained. RESULTSOut of the total 160 babies born with MSAF, 68 (42.5%) were female and 92 (57.5%) were male. MAS was seen in 21 (13.12%) babies. It was observed that there is significant association between MAS & MSAF and the following risk factors like Post maturity (1.25%), Small for Gestational Age (SGA) (11.25%), Oligohydramnios (4.38%) and low APGAR (5.62%). MAS babies who required ventilation (CPAP & IMV) were 9 (42.85%). The mortality observed in our study was 5 (23.80%), and the rest of the 16 MAS babies were discharged without any complications. CONCLUSIONMSAF and MAS affect mostly full term and post-term babies. MAS has significant effect on neonatal outcome when it is associated with risk factors like post-term gestation, SGA, Oligohydramnios, APGAR score < 7. These babies required ventilator support, hence they require continuous and close monitoring in a tertiary care setting. MSAF and MAS can be prevented by appropriate antenatal and natal care by the obstetrician and neonatologist. HOW TO CITE THIS ARTICLE: Avula TR, Bollipo S, Potharlanka S. Meconium-stained amniotic fluid and meconium aspiration syndrome-A study on risk factors and neonatal outcome. KEYWORDS