Neonatal Outcome in Patients with Meconium Stained Liquor

2021 ◽  
Vol 15 (8) ◽  
pp. 2130-2131
Author(s):  
Fozia Liaquat ◽  
Erfa Sehar Anis ◽  
Uzma Altaf ◽  
Uzma Aziz ◽  
Nosh Afreen

Objective: determine the neonatal outcome in patients with meconium stained liquor. Setting: Gynaecology Deptt, Unit-III, Jinnah Hospital, Lahore. Methodology: In this study we included a total of 150 cases with singleton pregnancy (on USG), Cephalic presentation (on USG), Gestational age 37 completed weeks to 42 weeks (calculated from LMP) with meconium stained liquor observed during labour by the attending doctor whereas those with breech presentation, they were excluded by clinical examination and ultrasound, Still birth, they were excluded by ultrasound, and Congenital fetal anomalies, they were excluded by ultrasound. Complete abdominal pelvic examination was done. The subjects were followed till delivery and neonatal outcome i.e. birth asphyxia & meconium aspiration syndrome by the researcher herself. Results: In our study, most of the patients i.e. 64.67%(n=97) were between 18-30 years of age range, mean age was 27.93+4.82 yrs while frequency of neonatal outcome in patients with meconium stained liquor reveals as 2.67%(n=4) having Birth asphyxia while 34.67%(n=52) had Meconium aspiration syndrome. Conclusion: The frequency of meconium aspiration syndrome(MAS) is higher among patients with meconium stained liquor. Keywords: Meconium stained liquor, neonatal outcome, birth asphyxia, meconium aspiration syndrome, frequency.

2021 ◽  
Vol 37 (5) ◽  
Author(s):  
Muhammad Sohail Arshad ◽  
Mudasser Adnan ◽  
Hafiz Muhammad Anwar-ul-Haq ◽  
Arif Zulqarnain

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.


2018 ◽  
Vol 5 (3) ◽  
pp. 726
Author(s):  
Ravi Garg ◽  
Rupesh Masand ◽  
Chaman Ram Verma ◽  
Girdhari Lal Sharma ◽  
Suman Ankit Yadav

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.


2021 ◽  
pp. 1-4
Author(s):  
Mithilesh Kumar ◽  
R. K. Sinha ◽  
Debarshi Jana

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.


2019 ◽  
Vol 26 (11) ◽  
pp. 1815-1819
Author(s):  
Mirza Liaqat Ali ◽  
Naila Jabbar ◽  
Abdul Hannan ◽  
Azher

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.


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

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.


2017 ◽  
Vol 4 (6) ◽  
pp. 2142
Author(s):  
Ravindra Nath Gangu Dhilli ◽  
Penchalaiah A.

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. 


2021 ◽  
Vol 8 (6) ◽  
pp. 1021
Author(s):  
Preeti Uniyal ◽  
B. P. Kalra ◽  
Sanober Wasim

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.


2021 ◽  
pp. 48-50
Author(s):  
Neha Agarwal ◽  
Samta Bali Rathore ◽  
Shivani Baberwal-

BACKGROUND: Occurance of meconium-stained amniotic uid (MSAF) during labour may be considered as a measure for prediction of poor fetal outcomes such as meconium aspiration syndrome and perinatal asphyxia ,resulting in perinatal as well as neonatal morbidity and mortality. It constitutes about 5% of deliveries with meconium stained amniotic uid and death results in about 12% of infants with MAS. METHODS: 40 cases of meconium stained liquor detected after spontaneous or artical rupture of membranes taken during labour from june 2020 to december 2020 and their outcome in terms of mode of delivery(whether vaginal delivery or lower segment caesarean section) and fetal outcome and associated maternal high risk were studied RESULT: Anemia was co existant in around 15%, pregnancy induced hypertension(PIH) in 25%and premature rupture of membrane in 10%.Pregnancies complicated with Pregnancy induced hypertension had signicant higher rate of meconium stained liquor among all cases. Caesarean Section was commonly performed in meconium stained amniotic uid cases and accounted for about 65%of all cases. CONCLUSIONS: Meconium Stained amniotic uid increases the chances of caesarean rates,leading to birth asphyxia ,Meconium Aspiration Syndrome and hence increases the chances of neonatal intensive unit admission.


2018 ◽  
Vol 56 (209) ◽  
pp. 510-515 ◽  
Author(s):  
Susana Lama ◽  
Shyam Kumar Mahato ◽  
Nagendra Chaudhary ◽  
Nikhil Agrawal ◽  
Santosh Pathak ◽  
...  

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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