Etiological factors, clinical profile and outcome of meconium aspiration syndrome babies


  • R. Sasivarathan Department of Paediatrics, Government Mohan Kumaramangalam Medical College Hospital, Salem, Tamil Nadu, India
  • A. Logesh Anand Department of Paediatrics, Government Mohan Kumaramangalam Medical College Hospital, Salem, Tamil Nadu, India



Downe’s score, Fetal distress, Meconium staining, Very low birth weight


Background: Meconium staining of amniotic fluid has for long been considered to be a bad predictor of the fetal outcome because of its direct correlation of fetal distress, and increased the likelihood of inhalation of meconium, resultant deleterious effects on the neonatal lung. To evaluate etiological factors and severity of MAS in the study group.

Methods: This study was done in the Neonatal intensive care unit of the Department of Paediatrics, Government Mohan Kumaramangalam Medical College Hospital Salem, Tamil Nadu, India in the year 2018. Complete maternal and neonatal details were recorded in to the proforma. Delivery details, resuscitation did were also recorded.

Results: In present study, fetal distress was found to be the most common (42.5%) factor associated with MAS followed by PIH (21.6%) and PROM (17%). 22 (9.1%) cases were associated with Postdatism, 18 (7.5%) cases were associated with placental insufficiency. 88 babies had fetal distress (36.6%) prior to delivery. 138 babies had no fetal distress (57.5%).

Conclusions: MAS is known to cause severe respiratory distress and Downe’s score ranging between 4-8, usually a few hours after the onset of respiratory distress. Nearly 73.3% of the cases with MAS had birth asphyxia, out of which 30% had severe birth asphyxia. This indicates that passage of meconium can occur in utero, often considered a feature of the stressed fetus. Undoubtedly aspiration had occurred before delivery in these babies.


Osa AYK. Treatment of persistent pulmonary hypertension of the newborn. Update. Arch Dis Child. 1991;66:74.

Bochner CJ, Medearis AL, Ross MG, Oakes GK, Jones PA, Hobel CJ, et al. The role of antepartum testing in the management of post-term pregnancies with heavy meconium in early labor. Am J Obstet Gynecol. 1987;69(6):903-7.

Burke-Strick land M. Trecheo bronchial lavage in small infants. Minn Med. 1973;56:287.

Carson BS, Losey RW, Bowes Jr WA, Simmons MA. Combined obstet and pediatric approach to prevent MAS. Am J Obstet Gynecol. 1976;126(6):712-5.

Coltart TM, Byrne DL, Bates SA. Meconium aspiration syndrome, a 6 years retrospective study. Br J Obstet Gynecol. 1989;96(4):411-4.

Dooley SJ, Pesavento DJ, Depp R, Socol ML, Tamura RK, Wiringa KS. Meconium below the vocal cords at delivery correlation with intrapartum events. Am J Obstet Gynecol. 1985;153:767-70.

Falcigila HS. Failure to prevent meconium aspiration syndrome. Obstet Gynecol. 1988;71:349-53.

Fox WW, Gewitz MH, Dinwiddie R, Drummond WH, Peckham GJ, Pulmonary hypertension in the perinatal aspiration syndromes. Pediatrics. 1977;59(2):205-11.

Fujikura T. Klionsky B. The significant of meconium staining. Am J Obstet Gynecol. 1975;121(1):45-50.

Garson WM. Neonatal pulmonary hypertension, Pathophysiology, classification and etiology. Clin Perinatal. 1984;11:17-24.

Gooding CA, Gregory, GA Roentgenographic analysis of meconium aspiration of the newborn. Radiol. 1971;100(1):131-5.

Gregory GA, Gooding GA, Phibbs RH, Tooley WH. Meconium aspiration in infants. A prospective study. J Pediatrics. 1974;85:848-52.

Meis PJ, Hall M, Marshall JR, Hobel CJ. Meconium passage: a new classification for risk assessment during labor. Am J Obstet Gynecol. 1978;131(5):509-73.

Miller FC, Read JA. Intrapartum assessment of postdate fetus. Am J Obstet Gynecol. 1981;141(6):516-20.

Narang A. Definition of major illness as applicable at different levels of the health care delivery system. In: Sing M. Paul VK, Bhakoo ON, eds. 3rd Edition; Neonatal Nomenclature and Data Collection. New Delhi, National Neonatology Forum; 1989:27-35.

Patterson K, Kapur SP, Chandra RS. Persistent pulmonary hypertension of the newborn: pulmonary pathologic aspects. Perspect Pediatric Pathol. 1988;12:139-54.

Peterson JH, Pendleton ME. Contrasting roentgenographic pulmonary patterns of the hyaline membrane and fetal aspiration syndromes. Am J Roentgeno Rad Therapy Nuclear Med. 1955;74(5):800-17.

Rossi BE, Philipson EM, Williams TG, Kalhan SC. Meconium Aspiration Syndrome: Intrapartum and neonatal attributes. AM J Obstet Gynecol. 1989;161(5):1106-10.

Ting P, Brandy JJ. Tracheal suction in meconium aspiration. Am J Obstet Gynecol. 1975;122(6):767-71.

Tyler DC, Murphy J, Cheney FW. Mechanical and chemical damage to lung tissue caused by meconium aspiration. Ped. 1978;62(4):454-9.






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