Clinical profile of meconium aspiration syndrome in relation to birth weight and gestational age

Authors

  • Ravi Garg Department of Pediatrics, National Institute of Medical Sciences and Research, Jaipur, Rajasthan, India
  • Rupesh Masand Department of Pediatrics, National Institute of Medical Sciences and Research, Jaipur, Rajasthan, India
  • Chaman Ram Verma Department of Pediatrics, National Institute of Medical Sciences and Research, Jaipur, Rajasthan, India
  • Girdhari Lal Sharma Department of Pediatrics, National Institute of Medical Sciences and Research, Jaipur, Rajasthan, India
  • Suman Ankit Yadav Department of Pediatrics, National Institute of Medical Sciences and Research, Jaipur, Rajasthan, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20180981

Keywords:

Gestation, Meconium, Profile, Weight

Abstract

Background: Meconium aspiration syndrome (MAS) is commonly encountered entity in neonates delivered in rural health centres.

Methods: A prospective observational study was conducted in 50 consecutive cases of MAS who were admitted in Level III NICU of the Department of Pediatrics of a tertiary care teaching hospital located 50 kms from Jaipur city amidst rural surroundings from 1st January 2016 to 31st July 2017. Appropriate statistical analysis was carried out using Medcalc statistical software (version 16.4).

Results: Out of 3585 deliveries, prevalence of MSAF and MAS was 14% and 8.5% respectively. The M:F ratio of study subjects was 1.2:1.The maternal risk factors significantly associated with MAS were maternal anemia (p value-<0.001), maternal age >30 (p value-0.025) and unbooked pregnancies (p value-0.032). The mean birth weight was 2734±499gms. Majority of cases of MAS were seen in babies with birth weight between 2.5-3.5 kg (n=30, 60%).The mean gestational age was 38.6±2.4 weeks. 30 (60%) babies were delivered after completing 37-<40 weeks of gestation and 9 (18%) babies were of 40-<42 weeks of gestation. The common complications observed were exaggerated physiological hyperbilirubinemia (75%), birth asphyxia (50%) and septicaemia (27.08%). The commonest cause of mortality was birth asphyxia (57.14%) and pneumonia (42.8%).

Conclusions: MAS is a cause of concern for the attending obstetrician and pediatrician as it is associated with life threatening complications and mortality. Efforts need to be invested in promotion of institutional antenatal care and institutional deliveries so that maternal risk factors can be identified and managed effectively, especially in rural areas.

References

Ashtekar SD, Ashtekar RS, Kumbhar SK, Pilgulwar G, Gaikwad NK. Clinical study of meconium aspiration syndrome in relation to birth weight and gestational maturity at general hospital Sangli. MedPulse Int Med J. 2014;1(5):189-92.

Mundhra R, Aggarwal M. Fetal outcome in meconium stained deliveries. J Clin Diagnos Res. 2013;7:2874-6.

Unnisa S, Sowmya BS, Rao SB, Rajagopal K. Maternal and fetal out come in meconium stained amniotic fluid in a tertiary centre. Int J Reprod Contracept Obstet Gynecol. 2016;5(3):813- 17.

Ross MG. Meconium aspiration syndrome – more than intrapartum meconium. N Engl J Med. 2005;353(9):946-48.

Espinheira MC, Grilo M, Rocha G, Guedes B, Guimaraes H. Meconium aspiration syndrome - The experience of tertiary center. Rev Port Preumolo. 2011;17(2);71-6.

Antonowiez I, Schwachman H. Meconium in health and in disease. Adv Paediatr. 1979;26:275-310.

Gauchan E, Basnet S, Malla T. Meconium aspiration syndrome and neonatal outcome: a prospective study. Am J Public Health Res. 2015;3(5):48-52.

Swain P, Thapalial A. Meconium stained amniotic fluid – a potential predictor of meconium aspiration syndrome. J Nepal Paediatr Soc. 2008;28(1):3-6.

Firdaus U, Ali SM, Sachdeva S. Maternal and neonatal factors associated with meconium stained amniotic fluid. Curr Pediatr Res. 2013;17(1):37-40.

Patil KP, Swamy MK, Samatha K. A one year cross sectional study of management practices of meconium stained amniotic fluid and perinatal outcome. Obstet Gynecol India. 2006;56:128-30.

Ramakishore AV, Subramanyam KL, Mahesh G. A study on meconium aspiration syndrome cases attending to Government general hospital, Anantapuramu, Andhra pradesh. Int J Res Health Sci. 2015;3(1):169-73.

Goud P, Krishna U. Significance of Meconium stained amniotic fluid in labour. J Obstet Gynecol India. 1989;39:523-6.

Chandran JR, Uma Devi N, Rajeshwary U. Risk Factors For meconium aspiration and mas (meconium aspiration syndrome) in neonates born through meconium stained amniotic fluid (Msaf) In a tertiary care centre in Malabar (Kerala). J Evol Med Dental Sci. 2013;2(49):09:9489-95.

Sankhyan N, Sharma VK, Sarin R, Pathania K. Predictors of meconium stained amniotic fluid: a possible strategy to reduce neonatal morbidity and mortality. J Obstet Gynecol India. 2006;56(6):514-7.

Bhide SS, Shendurnikar N, Aiyer S, Baxi SR. Neonatal outcome after meconium stained amniotic fluid. J Obstet Gynecol India. 1993;44:933-5.

Hanoudi BM, Murad AM, Ali AD. Meconium staining of amniotic fluid: a clinical study. Br J Med Med Res. 2014; 4(3):914-21.

Behera MK, Kulkarni SD, Gupta RK. Meconium aspiration syndrome: a clinical study. Med J Armed Forces India. 1998;54(1):19-20.

Fischer C, Rybakowski C, Ferdynus C, Sagot P, Gouyon JB. A Population-based study of meconium aspiration syndrome in neonates born between 37 and 43 weeks of gestation. Int J Pediatr. 2012;2012:321545.

Sangeetha T, Ramanathan R. A study of meconium aspiration syndrome in neonatal intensive care unit at Rajah Muthiah Medical College, Chidambaram. Int J Modn Res Revs. 2016;4(9):1258-60.

Errkola R. Meconium aspiration syndrome. Ann ChirGynecol Supple. 1994; 208:106-09.

Eiden RD, Seitert CS, Winegar A, Spellacy WN. Perinatal characteristics of uncomplicated postdates pregnancy. Obstect Gynecol. 1987;69(3 Pt 1):296-9.

Wiswell TE, Bent RC. Meconium staining and the meconium aspiration syndrome. Unresolved issues. Pediatr Clin North Am.1993;40:955-81.

Rossi EM, Philipson EH, Williams TG, Kalhan SC. Meconium aspiration syndrome. Intrapartum and neonatal attributes. Am J Obst Gynecol. 1989;161(5):1106-10.

Wiswell TE, Tuggle JM, Turner BS. Meconium aspiration syndrome: have we made a difference? Pediatrics. 1990;85(5):715-21.

Rajput U, Jain A. Impact of meconium stained amniotic fluid on early neonatal outcome. J Evol Med Dental Sci. 2013;2(45):8788-94.

Bhatia, P, Ela N. Fetal and neonatal outcome of babies in meconium stained amniotic fluid and meconium aspiration syndrome. J Obstet Gynecol India. 2007;57(6):501-4.

Report of National Neonatal Perinatal Database (NNPD) 2002-2003. Available at http://www.newbornwhocc.org/nnpo.html. Accesssed on October 20, 2017.

Narang A, Nair PMC, Bhakoo ON, Vashist K. Management of meconium stained amniotic fluid – A team approach. Indian Pediatr. 1993;30:9-13.

Abramovich DR, Gray ES. Physiologic fetal defecation in mid pregnancy. Obstet Gynecol. 1982;60(3):294-6.

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Published

2018-04-20

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