Clinico-radiological Observations in Meconium Aspiration Syndrome

Baldev Bhatia,Kailash Nath Agarwal,Nagendra Chaudhary,Nikhil Agrawal,Om Prakash Kurmi,Santosh Pathak,Shyam Kumar Mahato,Susana Lama

doi:10.31729/jnma.3340

Abstract

To understand and report the prevalence of meconium aspiration syndrome and the clinico-radiological features in a tertiary care hospital of western Nepal. 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. 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.

Highlights

To understand and report the prevalence of meconium aspiration syndrome and the clinico-radiological features in a tertiary care hospital of western Nepal
All babies fulfilling the first and any of the remaining criteria for diagnosing Meconium aspiration syndrome (MAS) admitted to neonatal intensive care units (NICUs), during the above mentioned period were included in the study
We studied the 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

Summary

Introduction

To understand and report the prevalence of meconium aspiration syndrome and the clinico-radiological features in a tertiary care hospital of western Nepal. Meconium aspiration syndrome (MAS), one of the most common causes of neonatal respiratory distress, is commonly noticed in babies with increased gestational age.[1,2] MSAF has been associated with fetal distress and has been recognized as a predictor of poor fetal outcome. Meconium staining of the amniotic fluid (MSAF) is usually carried out in approximately 10-15% of childbirths, of which approximately 5-12% of new born are diagnosed with MAS.[3,4,5]. Many perinatal risk factors have been associated with meconium aspiration including placental insufficiency, maternal hypertension, maternal diabetes mellitus, preeclampsia, oligohydramnios, and maternal tobacco use. Perhaps the most significant risk factor for meconium aspiration is intrauterine growth retardation (IUGR) and post-term delivery.

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