Respiratory distress in vigorous babies born through meconium stained amniotic fluid: incidence, onset, risk factors and predictors at birth

Abstract

Background: One in every seven pregnancies ends with meconium-stained amniotic fluid (MSAF). MSAF can be harmful to the newborn with short and long-term sequelae. This study was aimed to find out the incidence, predictors, onset and severity of respiratory distress among vigorous babies born through meconium stained amniotic fluid which may or may not be evident at birth.Methods: It is a prospective observational study. One hundred forty-one neonates were studied. Data was collected on perinatal risk factors, clinical course and development of respiratory distress. Significance of the perinatal risk factors were identified by fisher’s exact test (p-value) and score based on odds ratio was assigned for significant risk factors. Results: This study included one hundred and forty-one vigorous babies born through meconium stained amniotic fluid, of which 36.9% (52) babies developed respiratory distress. Of the 52 babies who developed respiratory distress 19.23%(10 babies) developed meconium aspiration syndrome (MAS). In our study, it was observed factors like caesarean section and thick meconium increased risk of respiratory distress in the neonates born through meconium stained amniotic fluid who were vigorous.Conclusions: The incidence of respiratory distress in vigorous babies born through meconium stained liquor in this study was observed to be 36.9% (52 babies). 98.07% (51 babies) developed respiratory distress at birth or within one hour of life. All the babies who developed MAS had mild or moderate form of MAS. None of the babies required assisted ventilation. Risk factors like thick meconium, caesarean section showed significant increase in the incidence of respiratory distress. Therefore intrapartum monitoring and timely intervention can prevent the complications of MAS.

Clinical Profile and Short Term Outcome of Hypoxic Ischemic Encephalopathy Among Birth Asphxiated Babies in a Tertiary Care Hospital

“…Out of the 20 babies who expired 15 (75%) babies had a history of meconium stained liquor. Meconium stained liquor has strongly been associated with fetal distress in various studies 17 . Every seventh pregnancy suffers from meconium stained liquor and the frequency is increased in term and post term deliveries, 10-20% and 30-40% respectively.…”

“…Every seventh pregnancy suffers from meconium stained liquor and the frequency is increased in term and post term deliveries, 10-20% and 30-40% respectively. It is documented in 4% of deliveries less than 37 weeks of gestation 17 .…”