A Study of New Born Infant with Meconium Stained Amniotic Fluid

XXX CONGRÈS DE L’ASSOCIATION POUR L’ENSEIGNEMENT DE LA PÉDIATRIE EN EUROPE (A.E.P.E.)
jeudi 14 – vendredi 15 septembre 2000
LONDON. U.K.

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A Study of New Born Infant with Meconium Stained Amniotic Fluid. Effect and Outcome of Meconium Aspiration in Neonates in Urban Private Hospital
Manju Lata Sharma.
M.N. Hospital & Research, Centre Bikaner

Objectives
1. To find out incidence epidemiological correlates and outcome of meconium aspiration in neonates
2. To determine the risk of adverse neonatal outcome associated with meconium stained amniotic fluid
Setting: Urban Private Hospital – M.N. Hospital & Research Center, Bikaner.
Design: Prospective Study
Material and Methods
All newborns delivered consecutively in the time fram work from July 1998 to July 2000 were taken in to study. By this the live births with meconium stained amniotic fluid were assigned into first group MSAF group and a second group of non-meconium stained amniotic fluid Non MSAF which represents as Control Group. Both groups were compared with maternal factors like patity, antinatal and natal complications, foetal outcome. Relevant investigations such as chest X-ray, sepsis screening were also carried out. P value was used for statistical analysis.
Results
Meconium stained amniotic fluid neonates were found in 78 (9.79%) out of 796 deliveries (live birth) with a male to female ratio 1:1:1. Meconium aspiration syndrome was found in 13 (16.6%). Higher percentage meconium stained neonates (33.04%) were found from 42 weeks of gestation in comparison to the lesser percentage of (12.5%) between 37 – 41 weeks and (5.5%) less than 37 weeks. There was significantly higher percentage of heavier babies among meconium stained group (P<0.01). There were 81.8% appropriate for date, 9.09% small for date & large for date each. The difference was highly significant (P<0.001). Caesarean section accounted for about 45% of all modes of delivery in meconium stained neonates. Most of the primigravida mothers 45.22% showed meconium stained neonates. Spontaneous onset of labour was more common (84.5%) than induced labour (15.5%). During labour meconium stained amniotic fluid was more common in foetal distress (37.1%) compared to those without meconium stained 4.1% (P<0.001). No significant differences were observed between symptomatic meconium aspiration and asymptomatic meconium in relation to parity of mother, birth weight, gestational age and onset of labour.
The frequency of occurence of MAS was higher in thick meconium (58.9%), symptomatic meconium aspiration cases showed yellow staining of umblical cord and 7.5 cc to 10 cc of meconium stained gastric aspirate. Patchy coarse infiltration and hyperinflation of chest on chest roentgenogram were found in 100% MAS cases But 65.5% in a asymptomatic cases.
The outcome of meconium aspiration syndrome were birth asphyxia (58.9%) hypoxic ischemic encephalopathy (30.7%) seizures (25.64%), airleak syndrome (12.8%) and death in 10.25% cases.
Conclusion
The incidence of meconium stained amniotic fluid is seen in 9.79% of live births and 16.6% develop meconium aspiration syndrome. It usually occurs in term and post term infants with foetal distress. It is mostly seen in primigravida mothers and Caesarean section is the common mode of delivery. Meconium aspiration syndrome was found in 16.6% cases and outcome is usually cause morbidity or mortality to neonate. The neonatal mortality due to meconium aspiration syndrome is 10.25%.
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