Study of risk factors, clinical profile, and outcome in meconium-stained deliveries

Abstract

Background: The presence of meconium in amniotic fluid is a serious sign of fetal distress which leads to an increase in neonatal mortality. Objective: The objective of this study was to study the risk factors, clinical profile, and outcome of babies born through meconium-stained fluid. Materials and Methods: This prospective observational study was conducted during the period from February 2018 to October 2018 at neonatal unit of a tertiary care hospital. All live babies delivered through meconium-stained liquor were included in this study. Routine investigations such as complete blood count and C-reactive protein were done in all the patients. All the variables were analyzed with the help of the Chi-square test and Fisher’s exact test. Results: A total of 606 meconium-stained amniotic fluid (MSAF) babies were included in the study. Most of the MSAF babies were term, appropriate for gestational age babies. The number of babies delivered through the lower segment cesarean section was 61.7%. Fetal distress was present in 23.2% of the cases. Otherwise, the most common risk factor associated with MSAF was pre-eclampsia (5.9%). A total of 58.2% of babies developed respiratory distress after birth; other morbidities associated were convulsion, hypoxic-ischemic encephalopathy, sepsis, shock, hypoglycemia, and hyperbilirubinemia. In the present study, total mortality in MSAF babies was 12%. Babies who expired had severe meconium aspiration syndrome. Duration of hospital stay was <7 days in 83.9% of the neonates, of which 14% expired and 85% were discharged. All the mortalities in our study except one occurred within 7 days of life. Conclusion: MSAF is associated with significant morbidity and mortality in neonates. Mortality was more in non-vigorous babies and in those who developed severe meconium aspiration syndrome and pulmonary hypertension of the newborn. Other morbidities did not have a strong association with MSAF.

Outcomes and Associated Factors of Babies Diagnosed With Meconium Aspiration Syndrome (Mas): A Case Control Study

“…The association between fetal distress and MSAF has been reported in many studies [8]. Shukla and Swapna's observed that 23.7 percent of patients with the MSAF exhibit fetal distress [9].…”

Neonates Born Through Meconium-stained Amniotic Fluid among Deliveries in a Tertiary Care Centre: A Descriptive Cross-sectional Study

“… 4 - 6 The most common complication of MAS is Respiratory distress and other morbidities were convulsions, sepsis, shock, hypoxic-ischemic encephalopathy, hyperbilirubinemia and hypoglycemia. 13 …”

“…Meconium-stained amniotic fluid not only poses risk to the newborn but also significantly increases the rate of maternal complications such as meconium-laden amniotic fluid embolism, intrapartum chorioamnionitis, puerperal endometritis, wound infection, increased risk of operative delivery and its complication. 13 , 14 The perinatal morbidity and mortality related to MSAF can be decreased if major risk factors are recognized early and closely monitoring of the labour and careful decisions are made about the timing and mode of delivery. 14 …”