Meconium Aspiration Syndrome A Clinical Study

Abstract

ABSTRACT

Background: Meconium aspiration presents a special problem in delivery room management. A difference of clinical opinion regarding significance of meconium passage exists and much of controversy is focused on whether this phenomenon is physiological or pathological

Objectives: To find out risk factors for meconium aspiration; to assess the benefit of endotracheal intubations and suction in resuscitation of infant delivered through meconium stained amniotic fluid and to study various complication associated with this condition.

Methods: A prospective case control study was conducted on twenty-three (23) neonates with meconium aspiration syndrome; who were born in Al-Yarmouk Teaching Hospital and admitted to special care baby unit  during the period of study from the 1st of July 2009 – 31st of December 2009. A standardized data sheets were prepared for collection of information including sex, gestational age, birth weight, mode of delivery, fetal presentation, Apgar score, type of resuscitation and treatment, associated complication and duration of hospitalization

Results: It was found that meconium aspiration syndrome constitute (0.82%) of total live births and (9.1%) of total admission to special care baby unit. It usually occurs in term and post-term babies, but rarely in preterm babies even under stressful condition. Birth asphyxia, prolonged vaginal delivery with midwife interference and poor antenatal care were significant risk factors for meconium aspiration syndrome. It was more common in males than in females; and in those whose mothers were multiparus young women among age group 25-29 years; however, it was found that sex, breech presentation, maternal age and parity were not significant risk factors for it, whereas emergency cesarean section was significant protective factors against it. Tracheal suction was very valuable in the management of this syndrome. Almost all patients required oxygen administration and antibiotic cover for average 4.6 days. It was found that steroid therapy of little use and of no benefit in the management. Of the 23 patients who were admitted to special care baby unit, one neonate (4.34%) died because of respiratory failure and two other neonates had developed complication which was pneumothorax, but they were managed successfully and survived.

Conclusions: Birth asphyxia, prolonged difficult labor and poor antenatal care are significant risk factors for meconium aspiration syndrome. Cesarean section acts as protective and preventive factor against this syndrome, whenever fetal distress picked up early. Tracheal suction is very valuable in the management