Yield of meconium in non-vigorous neonates undergoing endotracheal suctioning and profile of all neonates born through meconium-stained amniotic fluid: a prospective observational study

Viraraghavan, V R; Nangia, Sushma; Prathik, B H; Madarkar, Babu S; Rani, Deepshika; Saili, Arvind

doi:10.1080/20469047.2018.1508809

Cited by 16 publications

(7 citation statements)

References 24 publications

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“…16 The study done by Viraraghavan VR et al, showed that 3% of vigorous babies and 21.7% of nonvigorous babies developed MAS, which showed statistical significance between non-vigorous neonates and development of MAS (p <0.001). 11 The study done by Gurmeet et al showed that 33% of the cases with MAS expired and 67% of cases with MAS were discharged, which is almost similar to the present study. 8 The number of discharged cases were more than expired cases in patients with MAS, which is similar to the present study.…”

Section: Discussionsupporting

confidence: 91%

“…The study done by Rokade J et al, showed that 111 patients (56%) delivered by L.S.C.S which is almost similar to present study. 9 Most common maternal age group was between 21 to 30 years which can be comparable to the study done by Vaghela HP et al 10 A 93.7% of babies were vigorous and 6.2% were non-vigorous in present study, which did not match with the study done by Viraraghavan VR et al 11 The study done by Chaudhary R et al, showed that 15 babies (18.07%) required mechanical ventilation, which is similar to . 12 Akmal et al found out that 30% of babies developed MAS, which is similar to and mortality was 15% for those developing MAS.…”

Section: Discussionsupporting

confidence: 57%

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Study of respiratory complications and outcome in meconium stained deliveries

Shukla

Swapna

2019

Int J Contemp Pediatr

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Background: To study the development of respiratory complications in the form of meconium aspiration syndrome (MAS), persistent pulmonary hypertension of newborn (PPHN), pulmonary hemorrhage and pneumothorax in neonates born through meconium stained liquor.Methods: It was a prospective study conducted during the period of February to October 2018. All live babies associated with meconium stained liquor were included.Results: Total 606 neonates with meconium stained amniotic fluid (MSAF) were enrolled. Chance of meconium passage was more after 37wk of gestation, in birth weight >2.5 kg and in AGA babies. The rate of LSCS was higher in MSAF group. MAS developed in 28% cases, out of which 42.9% expired. PPHN developed in 6.9% cases, out of which 80% expired. 100% mortality was there in babies with pulmonary hemorrhage. Apgar scores <7 is significantly associated with the development of respiratory complications. 22.8% of vigorous babies and all non-vigorous babies developed respiratory complications showing statistical significance with P-value of <0.00001. Mortality in MSAF was 12%. All babies who expired had severe meconium aspiration syndrome. 83.9% of the patients stayed for <7 days in the hospital. All of the expiry except one occurred within 7 days of life due to development of respiratory complications.Conclusions: MSAF is associated with the development of respiratory complications and mortality in neonates. Non-vigorous babies and the babies with Apgar scores <7 at birth are more prone to developing respiratory complications. Most of the MSAF babies were discharged and mortality was more in patients with respiratory complications.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 57%

Study of respiratory complications and outcome in meconium stained deliveries

Shukla

Swapna

2019

Int J Contemp Pediatr

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“…These results further augment the hypothesis that aspiration of meconium might be an in-utero phenomenon and that routine postnatal tracheal suctioning in NV MSAF neonates might be of limited benefit. 13 38 Comparison of baseline characteristics of the two groups in our study indicated that the “no ET suction” prospective group had a higher proportion of neonates who were of male gender and SGA. Despite the preponderance of such biological factors known to be associated with adverse outcomes such as increased mortality, the incidence of MAS being similar in both the groups is encouraging.…”

Section: Discussionmentioning

confidence: 74%

Outcomes of Nonvigorous Neonates Born through Meconium-Stained Amniotic Fluid after a Practice Change to No Routine Endotracheal Suctioning from a Developing Country

et al. 2022

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Objective: International Liaison Committee on Resuscitation (ILCOR) 2015 gave a weak recommendation based on low certainty of evidence against routine endotracheal (ET) suctioning in non-vigorous (NV) neonates born through meconium stained amniotic fluid (MSAF) and suggested for immediate resuscitation without direct laryngoscopy. A need for ongoing surveillance post policy change has been stressed upon. This study compared the outcomes of NV MSAF neonates before & after implementation of the ILCOR 2015 recommendation. Study Design: Prospective cohort study of term NV MSAF neonates who underwent immediate resuscitation without ET suctioning (No ET group, July 2018-June 2019, n=276) compared with historical control who underwent routine ET Suction (ET group, July 2015- June 2016, n=271). Results: Baseline characteristics revealed statistically significant higher proportion of male gender and small for gestational age neonates in the prospective cohort. There was no significant difference in the incidence of primary outcome of meconium aspiration syndrome (MAS) between the groups (No ET group: 27.2% vs ET group: 25.1%; p=0.57). NV MSAF neonates with hypoxic ischemic encephalopathy (HIE) was significantly lesser in the prospective cohort (No ET group: 19.2% vs ET group: 27.3%; p=0.03). Incidence of air leaks and need for any respiratory support significantly increased after policy change. In NV MSAF neonates with MAS, need for mechanical ventilation (MV) (No ET group: 24 % vs ET group: 39.7 %; p=0.04). and mortality (No ET group: 18.7% vs ET group: 33.8%; p=0.04) were significantly lesser. Conclusion: Current study from a developing country indicates that immediate resuscitation and no routine ET suctioning of NV MSAF may not be associated with increased risk of MAS and may be associated with decreased risk of HIE. Increased requirement of any respiratory support and air leak post policy change needs further deliberation. Decreased risk of MV and mortality amongst those with MAS was observed.

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“…20,21 Viraraghavan et al studied that mortality was significantly higher in the non-vigorous than vigorous neonates with (p<0.001), which is in accordance with our study in which 85% among 20 non vigorous neonates expired. 22 Besides this, intrapartum or postpartum endotracheal suctioning of neonates (vigorous babies) born through MSAF should not be done according to current guidelines, while suggesting expectant management. 23…”

Section: Discussionmentioning

confidence: 99%

Risk factors, clinical characteristics and outcome in neonates with meconium aspiration syndrome - an experience at tertiary care hospital

Chesti¹,

Sattar²,

Goswami³

et al. 2022

Int J Contemp Pediatr

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Background: Meconium aspiration syndrome (MAS) is a life-threatening condition involving respiratory system, the present study was undertaken to study maternal risk factors associated with MAS, etiology, incidence of MAS born via meconium-stained amniotic fluid (MSAF) and to assess outcome of neonates born with MAS. Methods: The present study was carried out at Government Medical College, Baramulla from August 2017 to August 2019, all neonates fulfilling inclusion criteria got admitted in neonatal intensive care unit (NICU) and were included in our study after obtaining informed consent from their parents. The demographic and factors related to MAS were recorded through predesigned proforma and analyzed using Microsoft excel. Mean and standard deviation were determined for quantitative variables whereas frequency and percentages were calculated for qualitative variables. Results: Newborn with MAS were mostly depressed at birth and hypoxic ischemic encephalopathy (HIE stage III) was main cause of neonatal mortality, significantly contributing 37.5% of cases of MAS. Neonatal mortality in MAS was also associated with 5 minute low APGAR score. There was significant and strong association between the birth weight and mortality. Thick MSAF was significantly associated with need for mechanical ventilation and subsequently higher mortality. Conclusions: We conclude from our study that MAS is most commonly seen in term and post term babies with birth weight >2.5 kg. Risk factors should be identified and timely intervention should be done to reduce, mortality and morbidity in MAS.

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Yield of meconium in non-vigorous neonates undergoing endotracheal suctioning and profile of all neonates born through meconium-stained amniotic fluid: a prospective observational study

Cited by 16 publications

References 24 publications

Study of respiratory complications and outcome in meconium stained deliveries

Study of respiratory complications and outcome in meconium stained deliveries

Outcomes of Nonvigorous Neonates Born through Meconium-Stained Amniotic Fluid after a Practice Change to No Routine Endotracheal Suctioning from a Developing Country

Risk factors, clinical characteristics and outcome in neonates with meconium aspiration syndrome - an experience at tertiary care hospital

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