TO STUDY THE CLINICAL PROFILE OF MECONIUM ASPIRATION SYNDROME (MAS) IN NEONATES IN RELATION TO BIRTH WEIGHT, GESTATIONALAGE AND THEIR IMMEDIATE OUTCOME

Study the clinical profile of meconium aspiration syndrome (MAS) in neonates, in relation to birth weight, gestational age and their immediate outcome. Prospective observational cross sectional study. All preterm, term and post term infants, appropriate for gestational age with birth weight, delivered normally or by caesarean section or forceps, fulfilling all the inclusion criteria for MAS who were admitted to NICU, during the 9 months from January 2020 to September 2020 were included in the study. Over nine months' period, 574 neonates were admitted in NICU under that 312 neonates were in respiratory distress, out of which78 neonates were suffered with MAS. A detailed antenatal and natal history was elicited. Complications during delivery and details of resuscitation at birth, was done wherever required. Endo-tracheal intubation was done and bag and tube ventilation was given wherever needed. In MAS neonates, APGAR score at 1 minute and 5 minutes and gestational age was assessed with New Ballard’s score. A detailed clinical examination was carried out and respiratory distress was monitored by using Downes score system. Score > 6 was taken as an indication for assisted ventilation. 574 babies were admitted to NICU during the study period and out of them 312 were with respiratory distress. During the study period 78 (25%) babies had MAS. Conservative management was given to 59 cases (75.64%) and only 19 cases (24.36%) needed artificial ventilation, where indication was birth asphyxia, acute respiratory failure or other complications like pneumothorax. Out of 19 ventilated babies, 15 babies died and 4 babies survived and were discharged in good health. Conclusions: 1.Increased incidence of meconium aspiration syndrome was associated with increase in the gestational age (more in term and post term neonate, birth weight > 2.5kgs, 2. Highest mortality was associated with thick meconium and with low APGAR score at 5 minutes.

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Profil Sindrom Aspirasi Mekonium pada Bayi Baru Lahir di RSUD Dr. Soetrasno Rembang

Smart Medical Journal ◽

10.13057/smj.v1i2.28692 ◽

2019 ◽

Vol 1 (2) ◽

pp. 42

Author(s):

Ahimsa Yoga Anindita ◽

Dwi Hidayah ◽

Yulidar Hafidh ◽

Annang Giri Moelyo ◽

Mayasari Dewi

Keyword(s):

Birth Weight ◽

Amniotic Fluid ◽

Gestational Age ◽

Apgar Score ◽

Meconium Aspiration Syndrome ◽

Normal Birth Weight ◽

Term Infants ◽

Meconium Aspiration ◽

Normal Birth ◽

Minute Apgar Score

Introduction: The presence of meconium in amniotic fluid occurs in 13% of live births in developing countries. This condition develops when the gestational age increases at delivery. Meconium aspiration syndrome occurs in 5% of newborns in meconium stained amniotic fluid. The aim of this study is to determine the profile of newborns who experience meconium aspiration syndrome (MAS) who are treated at Dr. Soetrasno Hospital, Rembang and its outcome.Methods: Prospective study, data were obtained from medical records of Dr. Soetrasno Hospital, Rembang during September to October 2018, on newborns with MAS.Results: Of 12 newborns with MAS were obtained, consisting of 7 (58.3%) male and 5 (41.7%) female. All cases were term infants (gestational age above 37 weeks) and normal birth weight (above 2500 grams). Based on the first minute APGAR score, there were 4 newborns had score 1 and 2, respectively (33.3%). Based on the fifth minute APGAR score, there were 7 newborns had score 3 (58.3%). The outcome of newborns with MAS were 7 alive (58.3%) and 5 died (41.7%).Conclusion: There were 12 newborns suffering from MAS (54.5%) of 22 babies hospitalized at the NICU dr. Soetrasno Hospital Rembang. All newborns with MAS were term infants and normal birth weight. There were 5 newborns with MAS which required invasive mechanical ventilation (intubation) and all died (41.7%).

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Etiology and frequency of respiratory distress in neonates: A cross sectional study conducted in tertiary care hospital, Lahore.

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.11.245 ◽

2019 ◽

Vol 26 (11) ◽

pp. 1815-1819

Author(s):

Mirza Liaqat Ali ◽

Naila Jabbar ◽

Abdul Hannan ◽

Azher

Keyword(s):

Respiratory Distress ◽

Gestational Age ◽

Tertiary Care ◽

Birth Asphyxia ◽

Cross Sectional Study ◽

Meconium Aspiration Syndrome ◽

Care Hospital ◽

Cross Sectional ◽

Meconium Aspiration ◽

New Born

Respiratory distress in neonate defines as when rate of respiration is greater than sixty in one minute, nasal flaring, grunting and intercostal / sub coastal recession is present. Various causes are reported of respiratory distress in new born. Objectives: To determine frequency of respiratory distress in new born and to Find frequency of various etiologies of respiratory distress in full term newborn admitted up to the age of 24 hours of birth in Study Design: Cross sectional studies. Setting: Neonatal unit of Jinnah Hospital Lahore. Period: From February 10, 2016 till August 10, 2016. Material and Method: SPSS v-20 was used for analysis of data like name, age, sex, gestational age, maternal record of pregnancy and fetus for etiologies of respiratory distress. Results: There were 100(66.7%) male and 50(33.3%) females in this study. The mean gestational age of these newborn was 39.51±1.51 weeks. Respiratory distress was seen in 16(10.7%) of the cases. Transient tachypnea seen in 4(25%) of the cases, Meconium aspiration syndrome was diagnosed in 2(12.5%), Pneumothorax in 3(18.8%), Congenital pneumonia in 2 (12.5%), Sepsis in 6(37.5%) and Birth asphyxia 2 (12.5%) of early neonatal age were the common observed causes. Conclusion: Respiratory distress was 1/10 of the cases. The commonest etiologies were Sepsis preceding to Respiratory distress syndrome, MAS (Meconium Aspiration Syndrome), TTN (Transient Tacyhpnea of Newborn), Pneumothorax, Congenital pneumonia, Birth asphyxia.

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Study of clinical profile of meconium aspiration syndrome in relation to gestational age and birth weight and their immediate outcome at Narayana Medical College Hospital, Nellore, India

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20174747 ◽

2017 ◽

Vol 4 (6) ◽

pp. 2142

Author(s):

Ravindra Nath Gangu Dhilli ◽

Penchalaiah A.

Keyword(s):

Birth Weight ◽

Gestational Age ◽

Birth Asphyxia ◽

Fetal Distress ◽

Meconium Aspiration Syndrome ◽

Clinical Profile ◽

College Hospital ◽

Meconium Aspiration ◽

Meconium Staining ◽

A Prospective Study

Background: Meconium staining of the amniotic fluid occurs in approximately 13% of live births; this percentage increases with increasing gestational age at delivery. MAS occurs in approximately 5% of infants born through MSAF. This study was undertaken to understand the factors causing MAS and clinical profile of meconium aspiration syndrome in relation to gestational age and birth weight and their immediate outcome.Methods: The present study is a prospective study of 58 neonates admitted to NICU fulfilling the criteria of MAS were included in the study over a period of 2 years. The babies who were born with meconium stained liquor, suctioning was done by the obstetricians first at the delivery of shoulder and then handed over to pediatrician and depending upon whether the meconium is present below the vocal cords or not and whether baby is vigorous or not, endotracheal intubation and bag and tube ventilation was given. The babies with clinical features MAS were admitted to NICU and were observed for their immediate outcome in the hospital.Results: During the study period, out of 4994 deliveries, 882 (17.6%) babies had meconium stained liquor and out of these 882 babies, 58 (6.5%) babies had MAS. Out of 426 cases of respiratory distress admitted to NICU, 58 (13.6%) cases diagnosed of MAS. MAS occurred most commonly in babies having fetal distress and in mothers with history of PIH. It is seen more commonly in babies born through caesarean section and in term babies with mean gestational age of 38-40 weeks of gestation and mean birth weight of 2.68 Kg. It was most commonly associated with babies who were depressed at birth and most common cause of mortality was due to birth asphyxia contributing 37.5% of cases of MAS.Conclusions: MAS is an entity which is commonly seen in term and post term babies with birth weight >2.5 Kg.

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A study of profile of meconium aspiration syndrome in relation with birth weight and gestational age of newborns and their immediate outcome

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20212041 ◽

2021 ◽

Vol 8 (6) ◽

pp. 1021

Author(s):

Preeti Uniyal ◽

B. P. Kalra ◽

Sanober Wasim

Keyword(s):

Birth Weight ◽

Respiratory Distress ◽

Gestational Age ◽

Birth Asphyxia ◽

Maternal Diabetes ◽

Meconium Aspiration Syndrome ◽

P Value ◽

Meconium Aspiration ◽

Maternal Risk ◽

One Year

Background: Meconium aspiration syndrome (MAS) is one of the common causes of neonatal respiratory distress. Overall frequency of meconium stained amniotic fluid (MSAF) ranges between 5 to 25%.Methods: Observational study was conducted on 96 newborns over a period of one year in the department of pediatrics, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand. All newborns, inborns and outborns with MSAF admitted in NICU of our hospital were taken. Results: Out of 876 babies those had MSAF, 96 babies developed MAS with 10.95% incidence. Common maternal risk factors noted with MAS was maternal diabetes mellitus in 11 (15.71%) cases. Babies born via LSCS developed MAS in 51 (53.12%) and in babies delivered vaginally 45 (46.87%). MAS occurred mainly in term with mean gestational age of 38 weeks with SD of 1.85 weeks. The mean birth weight of newborns with MAS was 2794 g with 524 g SD. Most common complication was birth asphyxia in 36 (37.5%). Mortality occurred in 11 (11.4%). Mean gestational age and birth weight of mortality in MAS was 38 weeks with 2.5 weeks SD and 2800 g with 723 g SD respectively. Statistically significant association noted between mortality due to MAS and birth weight as p value<0.05, but no significant association noted between mortality and gestational age.Conclusions: MAS is a common cause of respiratory distress in newborns born through MSAF. With judicious use of available modes of ventilation and adjunctive therapies, infants with even the most severe MAS can usually be supported through the disease, with an acceptable burden of short-and long-term morbidity.

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Postnatal causes and severity of persistent pulmonary Hypertension of Newborn

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.37.5.2218 ◽

2021 ◽

Vol 37 (5) ◽

Author(s):

Muhammad Sohail Arshad ◽

Mudasser Adnan ◽

Hafiz Muhammad Anwar-ul-Haq ◽

Arif Zulqarnain

Keyword(s):

Pulmonary Hypertension ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Gestational Age ◽

Distress Syndrome ◽

Birth Asphyxia ◽

Meconium Aspiration Syndrome ◽

Persistent Pulmonary Hypertension ◽

High Morbidity ◽

Meconium Aspiration

Background & Objective: Persistent pulmonary hypertension of the newborn (PPHN) is described as severe respiratory failure along with hypoxaemia. PPHN is known to be linked with high morbidity and mortality around the world. This study was planned to determine the postnatal causes and assess the severity of persistent pulmonary hypertension of newborn in babies presenting to the Children’s Hospital, Multan. Methods: This observational study was conducted at the Department of Paediatric Cardiology, The Children Hospital &Institute of Child Health, Multan, Pakistan from July to December 2019. A total of 122 confirmed cases of PPHN admitted having gestational age above 34 weeks were enrolled. Demographic data of the newborns was recorded along with maternal medical history, pregnancy status and postnatal causes of PPHN. Severity of PPHN was also recorded. Results: Out of a total of 122 cases of PPHN, 81 (66.3%) were male. Majority, 78 (64.0%) had gestational age above 37 weeks. Mode of delivery as cesarean section was noted in 70 (57.4%). Meconium aspiration syndrome 52 (42.6%), birth asphyxia 48 (39.3%), respiratory distress syndrome 23 (18.8%) and sepsis 33 (27.0%) were found to be the commonest causes of PPHN. Severe PPHN was found to be the most frequent, noted among 63 (51.6%) while Moderate PPHN was observed in 40 (32.8%) and Mild PPHN in 19 (15.6%). Morality was noted among 26 (21.3%) of cases. Conclusion: Meconium aspiration syndrome, birth asphyxia and respiratory distress syndrome were the commonest postnatal causes of PPHN. Severe PPHN was found to be the most frequent form of PPHN. doi: https://doi.org/10.12669/pjms.37.5.2218 How to cite this:Arshad MS, Adnan M, Anwar-ul-Haq HM, Zulqarnain A. Postnatal causes and severity of persistent pulmonary Hypertension of Newborn. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.2218 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Clinical profile of meconium aspiration syndrome in relation to birth weight and gestational age

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20180981 ◽

2018 ◽

Vol 5 (3) ◽

pp. 726

Author(s):

Ravi Garg ◽

Rupesh Masand ◽

Chaman Ram Verma ◽

Girdhari Lal Sharma ◽

Suman Ankit Yadav

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Gestational Age ◽

Birth Asphyxia ◽

Meconium Aspiration Syndrome ◽

P Value ◽

Maternal Risk Factors ◽

Meconium Aspiration ◽

Maternal Risk ◽

The Mean

Background: Meconium aspiration syndrome (MAS) is commonly encountered entity in neonates delivered in rural health centres.Methods: A prospective observational study was conducted in 50 consecutive cases of MAS who were admitted in Level III NICU of the Department of Pediatrics of a tertiary care teaching hospital located 50 kms from Jaipur city amidst rural surroundings from 1st January 2016 to 31st July 2017. Appropriate statistical analysis was carried out using Medcalc statistical software (version 16.4).Results: Out of 3585 deliveries, prevalence of MSAF and MAS was 14% and 8.5% respectively. The M:F ratio of study subjects was 1.2:1.The maternal risk factors significantly associated with MAS were maternal anemia (p value-<0.001), maternal age >30 (p value-0.025) and unbooked pregnancies (p value-0.032). The mean birth weight was 2734±499gms. Majority of cases of MAS were seen in babies with birth weight between 2.5-3.5 kg (n=30, 60%).The mean gestational age was 38.6±2.4 weeks. 30 (60%) babies were delivered after completing 37-<40 weeks of gestation and 9 (18%) babies were of 40-<42 weeks of gestation. The common complications observed were exaggerated physiological hyperbilirubinemia (75%), birth asphyxia (50%) and septicaemia (27.08%). The commonest cause of mortality was birth asphyxia (57.14%) and pneumonia (42.8%).Conclusions: MAS is a cause of concern for the attending obstetrician and pediatrician as it is associated with life threatening complications and mortality. Efforts need to be invested in promotion of institutional antenatal care and institutional deliveries so that maternal risk factors can be identified and managed effectively, especially in rural areas.

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To Study the Complications of Meconium Aspiration Syndrome & their Outcome In Relation to Gestational Age & Birth Weight In Tertiary Health Care Centre

VIMS Health Science Journal ◽

10.46858/vimshjs.7203 ◽

2020 ◽

Vol 7 (2) ◽

pp. 47-49

Author(s):

Dr. Kajalkumari Jain ◽

Dr. Ramesh B. Kothari ◽

Dr. Sunil Natha Mhaske ◽

Dr. Ganesh B. Misal ◽

Dr. Ujjwala Shirsath

Keyword(s):

Birth Weight ◽

Gestational Age ◽

Tertiary Care ◽

Birth Asphyxia ◽

Meconium Aspiration Syndrome ◽

Hypoxic Ischemic Encephalopathy ◽

Care Centre ◽

Tertiary Care Centre ◽

Meconium Aspiration ◽

Ischemic Encephalopathy

Neonates born through meconium stained amniotic fluid,2-3% of them develop Meconium Aspiration Syndrome. Out of them,5-10% of them develop complications. Meconium Aspiration is typically seen in post-mature, small for date infants or a term infant with intrauterine hypoxia and in babies born with birth weight more than 2500gm.The objective is to study the complications of Meconium Aspiration Syndrome and their outcome in relation to gestational age and birth weight. Methodology: It is an prospective observational study was carried out in NICU of tertiary care centre and included 32 cases of Meconium aspiration syndrome. Study was done in a period of 14 months in and around Ahmednagar district. Result: The complications are Hypoxic Ischemic Encephalopathy (HIE), Seizures, Septicaemia, Pneumonia, Persistent Pulmonary Hypertension(PPHN), Airleak. Outcome of meconium aspiration syndrome in relation to gestational age is maximum death of 56.25% occurred in term babies which were 18.Outcome of meconium aspiration syndrome in relation to birth weight is maximum death of 53.12% occurred in neonates weighing between 2.5 to 3.5 kg which were 17. Conclusion: Meconium aspiration syndrome is seen in the new born period and contributes significantly to the neonatal morbidity and mortality. Severe Hypoxic ischemic encephalopathy being most common complication and birth asphyxia being most common cause of death.

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Surfactant Therapy in Full-term Neonates With Severe Respiratory Failure

PEDIATRICS ◽

10.1542/peds.92.1.135 ◽

1993 ◽

Vol 92 (1) ◽

pp. 135-139

Author(s):

Hatem Khammash ◽

Max Perlman ◽

Julian Wojtulewicz ◽

Michael Dunn

Keyword(s):

Respiratory Failure ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Oxygenation Index ◽

Meconium Aspiration Syndrome ◽

Full Term ◽

Surfactant Therapy ◽

Term Infants ◽

Meconium Aspiration

Objective. In light of the paucity of published data on the use of surfactant in full-term infants with respiratory failure due to meconium aspiration syndrome and respiratory distress syndrome, we report our experience with this therapy. Our goal was to explore possible justification for randomized controlled trials of surfactant treatment in similar patients at an earlier, less severe stage of the disease. Methods. Retrospective consecutive case series of 20 infants with severe meconium aspiration syndrome and 29 infants with severe respiratory distress syndrome who received bovine surfactant between March 1990 and December 1992 in three neonatal intensive care units in a regionalized setting. Outcome of treatment was assessed by comparing changes in several respiratory indices including the oxygenation index, between 4 and 6 hours and 1 and 3 hours before and after the first dose of surfactant. Differences were analyzed using analysis of variance for repeated measures, with treatment and time as co-variates. Results. In the meconium aspiration group the mean oxygenation index decreased from 36 ± 12 at 1 to 3 hours presurfactant to 24 ± 14 at 1 to 3 hours postsurfactant (P < .001). In the patients with respiratory distress syndrome the mean oxygenation index fell from 30 ± 17 at 1 to 3 hours presurfactant to 12 ± 6 at 1 to 3 hours postsurfactant (P = .0001). Three of 20 patients with meconium aspiration syndrome and 3 of 29 patients with respiratory distress syndrome received extracorporeal membrane oxygenation. Conclusions. Surfactant therapy in full-term infants with respiratory failure due to the meconium aspiration and respiratory distress syndromes is often effective in improving gas exchange. A randomized controlled trial of surfactant therapy at an earlier stage in the course of the illness should be performed.

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Morbidity and mortality of low birth weight babies in early neonatal period in a rural area teaching hospital, Telangana, India

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20192759 ◽

2019 ◽

Vol 6 (4) ◽

pp. 1582

Author(s):

Jayalakshmi Pabbati ◽

Preethi Subramanian ◽

Mahesh Renikuntla

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Respiratory Distress ◽

Gestational Age ◽

Neonatal Period ◽

Birth Asphyxia ◽

Morbidity And Mortality ◽

Neonatal Deaths ◽

Early Neonatal Period ◽

Preterm Babies

Background: A baby’s weight at birth is a strong indicator of newborn health and nutrition. Low birth weight (LBW) babies are more susceptible to morbidities and mortality in early neonatal period than normal birth weight (NBW) babies. Among neonatal deaths, 80% occurs in LBW / preterm babies and 75% of total neonatal deaths occur in early neonatal period. The present study was undertaken to know the incidence and early neonatal outcome of LBW babies in rural area.Methods: Prospective observational study was conducted in babies born with <2.5 kg (LBW) birth weight.Results: The incidence of LBW babies was 25.07% with almost an equal contribution from preterm (50.46%) and Term Intra Uterine Growth Restricted (IUGR) (49.53%) babies. The most common morbidity found in LBW babies was Jaundice (40.09%) followed by respiratory distress (18.16%), sepsis (8.72%) and apnea (4.48%). Preterm-LBW babies had more morbidities in terms of apnea (100%), birth asphyxia (88.88%), respiratory distress (87.01%%), sepsis (80.55%) and jaundice (67.64%). Early neonatal mortality was 21.22 per 1000 live births. Mortality was 100% for babies <1 kg in birth weight, 16% in 1-1.499 kg group and 0.75% in 1.5-2.499 kg group in early neonatal period. According to gestational age, mortality in preterm-LBW babies was 88.88% and 11.11% in Term IUGR-LBW babies. The most common cause of death in LBW babies was birth asphyxia (44.44%) followed by hyaline membrane disease (HMD) (33.33%).Conclusions: The present study revealed that preterm babies contributed 50% to incidence of LBW babies. Morbidity and mortality in LBW babies were inversely related to birth weight and gestational age.

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Clinico-radiological Observations in Meconium Aspiration Syndrome

Journal of Nepal Medical Association ◽

10.31729/jnma.3340 ◽

2018 ◽

Vol 56 (209) ◽

pp. 510-515 ◽

Cited By ~ 2

Author(s):

Susana Lama ◽

Shyam Kumar Mahato ◽

Nagendra Chaudhary ◽

Nikhil Agrawal ◽

Santosh Pathak ◽

...

Keyword(s):

Apgar Score ◽

Tertiary Care ◽

Mode Of Delivery ◽

Birth Asphyxia ◽

Meconium Aspiration Syndrome ◽

Care Hospital ◽

Radiological Findings ◽

Female Ratio ◽

Meconium Aspiration ◽

Significant Difference

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

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