Clinico-radiological Observations in Meconium Aspiration Syndrome

Abstract

Introduction: To understand and report the prevalence of meconium aspiration syndrome and the clinico-radiological features in a tertiary care hospital of western Nepal.
 Methods: An observational study carried out for a year in 2014-15 in all babies with MAS. Clinical and radiological profiles of MAS in relation to gender, gestational age, mode of delivery, birth weight, Apgar score, thickness of meconium, age at admission and the immediate outcome were studied.
 Results: Out of 584 admitted newborns (male=389; female=186) during the study period, 78 (13.4%) had meconium aspiration syndrome with male: female ratio of 1.2:1. Majority of babies admitted to NICU had thick meconium [n=52 (66.7%)]. There was no statistical significant difference in various parameters such as Apgar score at 1 and 5 minutes, respiratory distress, birth asphyxia, duration of oxygen use, MAS severity and chest x-ray in those with thick MAS compared to thin. Among all newborns with MAS, 59% (n=46) had abnormal radiological findings with over two-folds in those with thick MAS (71.7%)] compared to thin (28%). Hyperinflation (47.8%), diffuse patchy infiltration (37%), consolidation (21.7%) collapse (8.7%), right lung fissure (6.5%) and pneumothorax (8.7%) were the abnormal radiological findings seen in MAS babies. The odds of having APGAR score at 1 minute at least 7 or more was twice unlikely in those having thick meconium compared to thin (P=0.02)
 Conclusions: Thick meconium is relatively common with more significant abnormal radiological findings and low Apgar score.

Approach to the Connection between Meconium Consistency and Adverse Neonatal Outcomes: A Retrospective Clinical Review and Prospective In Vitro Study

“…Although numerous studies have reported no significant differences in adverse neonatal outcomes associated with meconium consistency [ 52 , 74 , 75 , 76 ], our clinical experience [ 77 ], and the results of this retrospective analysis suggest that thick meconium may serve as a clinical risk for adverse neonatal outcomes, including low APGAR scores at 1 min and 5 min, neonatal death, or the need for NICU admission, resuscitation, CPAP use, or ventilator use. Our findings agree with the results of several papers [ 4 , 21 , 22 , 78 , 79 , 80 ]. Maternal factors, including maternal age, delivery mode, and the presence of medical conditions such as preeclampsia, diabetes, antepartum hemorrhage, PROM, polyhydramnios and oligohydramnios, and neonatal factors including gestational age, birth weight, sex of the infant, and the prevalence of hypoglycemia have all been reported to be associated with the presence of MSAF [ 14 , 21 , 22 , 25 , 78 , 81 , 82 , 83 , 84 , 85 ].…”

A study of profile of meconium aspiration syndrome in relation with birth weight and gestational age of newborns and their immediate outcome

“…3 Caesarean section was very commonly done in MSAF cases and it accounted for 49.09% cases as compared to 25.79% cases in control group, rates being nearly double and difference being statistically significant in the study of Rajlaxmi et al 8 Lama et al also concluded higher rates of MAS in babies born through LSCS. 12 Naveen also concluded that chances of LSCS were more in MSAF babies. 13 The highest incidence of MAS was found in gestational age of 39-40 weeks 57.3% followed by 37-38 weeks in 25%.…”

The Influence of Perinatal Risk Factors on the Development of Meconium Aspiration Syndrome in Newborn: Important in the Routine Practice of Doctor-Neonatologist

“…За даними різних авторів, наявність меконію в навколоплідних водах спостерігається у 10-24 % всіх пологів [1,2,3,4,5,6]. Частота виявлення меконію у навколоплідних водах у 6 разів вища серед жінок з терміном вагітності 42 тижнів або більше порівняно з терміном 37 тижнів.…”