Publication: Associated Factors and Outcome of Babies Born Through Meconium Stained Amniotic Fluid
Date
2018
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
Neonates born through meconium stained amniotic fluid (MSAF) are associated with
significant morbidity and mortality.
Objective
To study the incidence, associated factors and outcome of meconium stained
amniotic fluid babies born in Dhulikhel hospital.
Method
Prospective, cross-sectional study conducted in Obstetric ward and Neonatal
Intensive Care Unit (NICU) from 15 December 2015 to 15 December 2016. All the
babies born through meconium stained amniotic fluid during the period were
included.
Result
Incidence of meconium stained amniotic fluid was 6.5%(167/2581). Meconium
aspiration syndrome (MAS) developed in 9(5.4%) among all meconium stained
amniotic fluid cases. Primigravidity and postdatism were observed more in Meconium
aspiration syndrome group than meconium stained amniotic fluid group (77.8%
VS 73.4%; 33.3% VS 26.3%). Babies delivered by caesarian section were more in
meconium stained amniotic fluid group than Meconium aspiration syndrome group
(47.5% VS 33.3%). All the babies with meconium stained amniotic fluid improved
except one baby with Meconium aspiration syndrome who expired. Neonatal sepsis
was a significant co-morbidity in Meconium aspiration syndrome group (P value=
0.008). There was increased incidence of operative delivery in thick meconium
stained amniotic fluid than thin meconium stained amniotic fluid (52.6% VS 38.9%).
Similarly, Neonatal Intensive Care Unit admission and neonatal complications like
Meconium aspiration syndrome, perinatal asphyxia and sepsis were more commonly
observed in thick meconium stained amniotic fluid group than thin meconium
stained amniotic fluid group.
Conclusion
The progression to meconium aspiration syndrome in babies with meconium stained
amniotic fluid is not associated with any maternal and neonatal factors studied. MAS
babies are 10 times more likely to require NICU admission and sepsis is a significant
co-morbidity. Thick meconium stained amniotic fluid is worrisome. There is increased
chance of operative delivery and neonatal complications if associated with thick
meconium stained amniotic fluid.
KEY WORDS
Meconium, Meconium aspiration syndrome, Meconium stained amniotic fluid
Description
Shrestha A,1 Singh SD,1 Tamrakar D2
1Department of Pediatrics
2Department of Community Medicine
Kathmandu University School of Medical Sciences
Dhulikhel, Kavre, Nepal
Keywords
Meconium, Meconium aspiration syndrome, Meconium stained amniotic fluid