DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20163138

Assessment of incidence, determinants and co-morbidities associated with meconium aspiration syndrome: a hospital based study

Suhaim Afsar, Naresh P. Motwani, Sudhakar C., Uma Chaturvedi

Abstract


Background:Meconium aspiration syndrome (MAS) was found to be major contributing factor towards perinatal morbidity and mortality. This condition is mainly accompanied with respiratory failure, pulmonary air leaks and pulmonary hypertension in neonates. A conservative approach of obstetrician-paediatrician combination moderates incidence of MAS and its complications. The objective of the study was to determine the incidence, determinants and co-morbidities associated with MAS in both intramural and out born admitted to the NICU and SNICU of a Chandulal Chandrakar memorial hospital located in Bhilai, Chattisgarh, India.

Methods: This was a prospective study conducted in Chandulal Chandrakar memorial hospital, Bhilai from 1st September 2013 to 31st February 2015, in newborns with history of meconium stained amniotic fluid (MSAF) in both out-born and inborn units. Neonates who met inclusion criteria they were included in the study. The data were recorded in predesigned proforma. The data was analyzed using Chi square test. Level of significance of this data was set at p <0.05.

Results:Incidence of MSAF in the in-born and out-born among all children admitted was 52.4% and 47.5% respectively. Out of total 202 subjects of MSAF, those with MAS were 29.7% and of these 75% were inborn and 25% were out-born. Male preponderance was high in the study compared to female babies. Incidence of MAS was significantly more in children of >2.5 kgs (80%) and common in primiparous mothers (60%) with lower segmental caesarian sections. MAS commonly seen in post -term babies (53.33%) than those of term (36.66%) or pre-term (10%) gestation. Fetal distress was the common complication observed in most of the cases (91.1%) and one death related to this was noted. At the end of 1 year there were predominantly more children (40%) who developed respiratory morbidities. Delayed development was seen among 13.3% children and transient tone abnormalities were noted in about 2% of infants.

Conclusions:The overall incidence of MAS was found to have been 30% among cases of MSAF, which was relatively higher due to delayed referral. This percentage could have been reduced along with associated co-morbidities with appropriate antenatal check-up’s and timely referral.


Keywords


MAS, Meconium stained amniotic fluid, Inborn, Out-born

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References


Ross MG. Meconium aspiration syndrome - more than intrapartum meconium. N Engl J Med. 2005;353:946-8.

Locatelli A, Regalia AL, Patregnani C, Ratti M, Toso L, Ghidini A. Prognostic value of change in amniotic fluid color during labor. Fetal Diagn Ther. 2005;20:5-9.

Elena M. Rossi, Elliot H, Philipson, Thomas G. Meconium aspiration syndrome: Intrapartum and Neonatal Attributes. American journal of obstetrics and gynaecology. 1989;161:1106.

Nizami SQ, Arif MA. Reapiratory distress syndrome among hospital born infants. Pak Paediatr J. 1985;9:276-82.

Wiswell TA, Bent RC. Meconium staining and the meconium aspiration syndrome, unresolved issues, In Pediatric clinics of North America. Updates on neonatalogy. 1993;40:955-81.

Brown BL, Gleicher N. Intrauterine meconium aspiration. Obstet Gynecol. 1981;57:26-9.

Cochran WG. Sampling techniques. 3rd ed. New York. John Wiley and Sons; 1977:81.

Orimadegun AE, Akinbami FO, Tongo OO, Okereke JO. Comparison of neonates born outside and inside hospitals in a children emergency unit, Southwest of Nigeria. Pediatr Emerg Care. 2008;24:354-8.

Owa JA, Osinaike AI. Neonatal morbidity and mortality in Nigeria. Indian J Pediatr. 1998;65:441-9.

Roy RN, Nandy S, Shrivastava P, Chakraborty A, Dasgupta M, Kundu TK. Mortality pattern of hospitalized children in a tertiary care hospital of Kolkata. Indian J Community Med. 2008;33:187-9.

Morbidity and mortality among outborn neonates at 10 tertiary care institutions in India during the year 2000. J Trop Pediatr. 2004;50:170-4.

Bhatia BD, Mathur NB, Chaturvedi P, Dubey AP. Neonatal mortality pattern in rural based Medical college hospital. Indian J Pediatr. 1984;51:309-12.

Gupta V, Bhatia BD. Meconium stained amniotic fluid: antenatal and neonatal attributes. Indian Paediatrics. 1996;33:293.

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

Davis RO, Philips JB III, Wilson ER, Huddleston JF. Fatal meconeum aspiration syndrome occurring despite airway management considered appropriate. American journal of obstetrics and gynaecology.1985;151(6):731-6.

Anwar Z, Butt TK, Anjum F, YaqubKazi Md. Mortality in meconium aspiration syndrome in hospitalized babies. Journal of the College of Physicians and Surgeons Pakistan. 2011;21(11):695-9.

Kenner C, Hirani AA. Safety issues in neonatal intensive care units in Pakistan. Newborn Infant Nurs Rev. 2008;8:69-71.

Khurshid A, Rashid J. Neonatal mortality in a district hospital setup. Ann King Edward Med Coll. 2005;11:373-6.

Gregory GA, Charles A, Roderic H. Meconium aspiration in infants: a prospective study. J Paediatr. 1974;85:848.