Risk Factors and Outcome of Neonates Born through Meconium Stained Amniotic Fluid in a Tertiary Hospital of Nepal

Abstract

Introduction: The incidence of meconium aspiration syndrome is still high in the developing world contributing significantly to the neonatal mortality. The study was aimed to know the risk factors contributing to meconium aspiration syndrome and neonatal outcome in a tertiary government hospital of the country.Materials and Methods: It was a hospital based cross sectional study done over a period of three months. All live newborns born through meconium stained liquor were enrolled and all the details regarding mother, neonate were recorded. Odd’s ratio and bivariate analysis was done to assess the risk factors for meconium aspiration syndrome.Result: Out of all the deliveries 14.6% were meconium stained amniotic fluid and meconium aspiration syndrome developed in 6.6% of the neonates. Low Apgar score and premature rupture of membranes was significantly associated with the risk of occurrence of meconium aspiration syndrome. Neonates who developed meconium aspiration syndrome had mortality of 11.3%.Conclusion: Perinatal asphyxia and premature rupture of membranes were significantly associated with the development of meconium aspiration syndrome and neonates who developed meconium aspiration syndrome had high mortality.J Nepal Paediatr Soc 2015;35(1):44-48

Fetal heart rate patterns in patients with thick meconium staining of amniotic fluid and its association with perinatal outcome

“…2 Gurubacharya SM, in a study based in Nepal found a higher association of PROM in subjects with MSAF. 10 Kumari R et al found MSAF was more common in post term pregnancies and with intrauterine growth restriction (IUGR). 3 Manohar et al in a study published in 2013 concluded that incidence of MSAF was more in pregnancy with crossed EDD (>40 weeks), oligohydroamnios, anemia and preeclampsia.…”

Meconium aspiration syndrome: incidence, associated risk factors and outcome‐evidence from a multicentric study in low‐resource settings in Nepal

“…Studies conducted in Nepal have revealed the incidence of MAS to be 6.6–8.6% and neonatal mortality as high as 11.3% . The incidence of MAS has declined in developed countries due to better obstetric practices and perinatal care; however, challenges remain persistent in the developing countries . Numerous studies have been carried out to identify possible risk factors associated with MAS.…”

“…Numerous studies have been carried out to identify possible risk factors associated with MAS. Risk factors such as ethnicity, longer gestational age (≥ 42 weeks), caesarean delivery, premature rupture of membranes and nulliparity have been identified …”

Neonates Born Through Meconium-stained Amniotic Fluid among Deliveries in a Tertiary Care Centre: A Descriptive Cross-sectional Study

“…The incidence of MAS was high in Nepal with an overall incidence of about 2.0 per 1000 live births. 11 Studies conducted in Nepal have revealed the prevalence of MSAF about 6.5%-14.6%, 8 , 9 , 12 among all live deliveries, the prevalence of MAS among MSAF about 6.6% to 8.6%, 8 , 12 and neonatal mortality from MAS about 5.4% to 11.3%. 8 , 9 , 12 The study conducted in India found the prevalence of MAS among MSAF as 7.7% to 21.5%, 4 - 6 and mortality among MAS as high as 13.8%.…”

“… 11 Studies conducted in Nepal have revealed the prevalence of MSAF about 6.5%-14.6%, 8 , 9 , 12 among all live deliveries, the prevalence of MAS among MSAF about 6.6% to 8.6%, 8 , 12 and neonatal mortality from MAS about 5.4% to 11.3%. 8 , 9 , 12 The study conducted in India found the prevalence of MAS among MSAF as 7.7% to 21.5%, 4 - 6 and mortality among MAS as high as 13.8%. 4 - 6 The most common complication of MAS is Respiratory distress and other morbidities were convulsions, sepsis, shock, hypoxic-ischemic encephalopathy, hyperbilirubinemia and hypoglycemia.…”