Continuous positive airway pressure in the treatment of meconium aspiration syndrome

Authors

  • Komal Dangriwal Department of Pediatrics, RNT Medical College, Udaipur, Rajasthan, India
  • Vivek Arora Department of Pediatrics, RNT Medical College, Udaipur, Rajasthan, India
  • Pankaj Narnolia Department of Pediatrics, RNT Medical College, Udaipur, Rajasthan, India
  • Ayushi Dhawal Department of Ophthalmology, RNT Medical College, Udaipur, Rajasthan, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20250412

Keywords:

Continuous positive airway pressure, Downe's score, Meconium aspiration syndrome, Neonatal respiratory distress

Abstract

Background: Meconium aspiration syndrome (MAS) is a significant neonatal condition, often associated with meconium-stained amniotic fluid (MSAF), fetal distress and severe respiratory complications. Management involves various forms of respiratory support, with continuous positive airway pressure (CPAP) being an effective, non-invasive option. This study aimed to assess the outcomes of CPAP therapy in neonates with MAS and identify predictors of success and failure in a tertiary care setting.

Methods: A descriptive observational study was conducted at the Paediatric Department of RNT Medical College, Udaipur, from January 2024 to July 2024. A total of 77 neonates with MAS were enrolled, with data collected on maternal complications, delivery mode, clinical status, and neonatal outcomes. CPAP was initiated in most cases, and its effectiveness was monitored.

Results: Fetal distress was present most commonly in newborns with maternal complications (55.26%), followed by pregnancy-induced hypertension (19.74%). Most infants were born via C-section (42.1%), with a mean birth weight of 2.53 kg. CPAP was successful in 85.53% of cases, with predictors of success including lower Downe’s scores. Severe asphyxia was the leading cause of mortality (13.16%).

Conclusions: CPAP is a highly effective treatment for moderate-to-severe MAS, offering advantages over mechanical ventilation in terms of reduced complications. Early initiation improves respiratory outcomes and reduces the need for invasive ventilation. Monitoring and early identification of risk factors, such as Downe’s score, are crucial for optimizing management.

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References

Fanaroff AA. Meconium aspiration syndrome: historical aspects. J Perinatol. 2008;28(Suppl 3):S3-7. DOI: https://doi.org/10.1038/jp.2008.162

Vain NE, Batton DG. Meconium "aspiration" (or respiratory distress associated with meconium-stained amniotic fluid?). Semin Fetal Neonatal Med. 2017;22(4):214-219. DOI: https://doi.org/10.1016/j.siny.2017.04.002

Whitfield JM, Charsha DS, Chiruvolu A. Prevention of meconium aspiration syndrome: an update and the Baylor experience. Proc (Bayl Univ Med Cent). 2009;22(2):128-31. DOI: https://doi.org/10.1080/08998280.2009.11928491

Rapoport S, Buchanan DJ. The composition of Meconium; isolation of blood group-specific polysaccharides; abnormal compositions of meconium in meconium ileus. Science. 1950;112(2901):150-3. DOI: https://doi.org/10.1126/science.112.2901.150

Balchin I, Whittaker JC, Lamont RF, Steer PJ. Maternal and fetal characteristics associated with meconium-stained amniotic fluid. Obstet Gynecol. 2011;117(4):828-35. DOI: https://doi.org/10.1097/AOG.0b013e3182117a26

Coughtrey H. Possible causes linking asphyxia, thick meconium and respiratory distress. Obstet Gynecol. 1991;31(2):97-102. DOI: https://doi.org/10.1111/j.1479-828X.1991.tb01791.x

Kaur R. A study on clinical profile of meconium aspiration syndrome in relation to gestational age and birth weight and their immediate outcome (Doctoral dissertation, Rajiv Gandhi University of Health Sciences (India)).

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

Gregory GA, Gooding CA, Phibbs RH, Tooley WH. Meconium aspiration in infants -A prospective study. J Pediatr. 1974;85(6):848-852. DOI: https://doi.org/10.1016/S0022-3476(74)80358-6

Wiswell TE, Bent RC. Meconium staining and the meconium aspiration syndrome. Pediatr Clin North Am. 1993;40(5):955-81. DOI: https://doi.org/10.1016/S0031-3955(16)38618-7

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Published

2025-02-24

How to Cite

Dangriwal, K., Arora, V., Narnolia, P., & Dhawal, A. (2025). Continuous positive airway pressure in the treatment of meconium aspiration syndrome. International Journal of Contemporary Pediatrics, 12(3), 467–470. https://doi.org/10.18203/2349-3291.ijcp20250412

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Original Research Articles