Early Neonatal Morbidity In Meconium Aspiration Syndrome

Abstract

Objective: To assess the frequency of early morbidity in neonates with meconium aspiration  syndrome.
Material and Methods: Neonates presented with respiratory distress along with meconium
staining of vocal cords and body on 1st day of life were admitted in Neonatology Ward of Services
Hospital. Neonates with dysmorphic features, congenital abnormalities of heart & lungs and risk
factors for sepsis were excluded from the study. A predesigned proforma was used to record
clinical data on presentation. This included necessary information like gestational age, weight,
gender and mode of delivery. The proforma was updated on daily basis to make note of any
complications arising during the course of hospital stay till outcome (discharge, leave against
medical advice or death).Arterial blood gases (ABGs) were done daily to look for persistent
hypoxia and Echocardiography was performed when ABGs and clinical examination suggested
development of persistent pulmonary hypertension of newborn (PPHN). Chest x-ray was done at
the time of admission and repeated if clinical findings were suggestive of pneumothorax. Other
investigations like blood culture were sent when there was clinical suspicion of sepsis. The data
was analyzed using SPSS (Statistical Package for the Social Sciences) version 20.0.
Results: 175 babies with meconium aspiration were included in the study. Complications like
pneumothorax was observed in 28babies (16%),persistent pulmonary hypertension of
newborn(PPHN) in 35(20%), respiratory failure in 21 (12%) and sepsis in 27 patients(15.4%). 45
patients died (25.7%), 90 were discharged home(51.4%) and 40 were referred to other hospitals
(22.8%).
It was observed that commonest risk factor for MAS was post-maturity, found in 40% with poor
APGAR score in 35.4%. About 60% patients were born at term while 40% were post mature.
There was no significant difference in morbidity between males and females.
Conclusion: It was observed that MAS is a leading cause of neonatal morbidity. It can be  prevented by giving appropriate peri-natal care to high risk pregnancies, vigilance and timely  intervention in delivery room.