Frequency and Outcome of Meconium Aspiration Syndrome in Babies Born with Meconium-Stained Liquor at Secondary Care Hospital in Pakistan: A Case Series Study

Background: Meconium aspiration syndrome (MAS) in the newborn is characterized by hypoxia, hypercapnia, and acidosis. MAS is a leading cause of morbidity and mortality in neonates. The primary objective of this study was to estimate the frequency of meconium aspiration syndrome (MAP) in babies born with meconium-stained liquor. The secondary outcome was to estimate the meconium aspiration syndrome;in terms of hospital stay, complications, and mortality. Methods: The study was done at Aga Khan Maternal and Child Care Centre, Hyderabad, Pakistan. Study design was case series and the duration of the study was of 6 months. All patients who fulfilled the inclusion criteria were included in the study after taking informed written consent. A brief history was taken, clinical examination was done and laboratory investigations were sent to the institutional laboratory. Study outcomes were measured from this data i.e. MAS, its complications, mortality, and a number of days in the hospital. Results: A total of 87 babies born with meconium-stained liquor at secondary care hospital were included. A total of 45 patients (52%) were males and 42 patients (48%) were females with a mean gestational age of babies 38.896 ± 1.210 weeks. The mean Apgar score at 5 minutes was 8.896 ± 0.404. MAS was present in 13 patients (14.9%). Complications were seen only one patient (1.1%) and there was no neonatal death reported. Discussion: MAS was present in 14.9% of babies;the complication of subacute bacterial infection was low seen in just 1.1% cases with no neonatal mortality.

ANALYSIS OF CLINICAL CHARACTERISTICS AND DEATH RELATED FACTORS OF SEVERE MECONIUM ASPIRATION SYNDROME

Objective To investigate the factors in relation with the case fatality in severe meconium aspiration syndrome (MAS). Methods Eighty-one severe MAS cases intervened by the mechanical ventilation from 9 childrens hospitals were retrospectively analyzed for the risk factors of fatality with SAS software for non-parametric rank sum test and chi-square test. Results In the 81 cases, 49 were survived (death rate 39%). The gestational age (GA), Apgars score at 1min and other complications with MAS were significantly related to the death (P <0.05). There was no difference of death rate between the patients with or without receiving endotracheal intubation and airway suctioning (P>0.05). Conclusion A higher death rate (close to 40%) of severe MAS in the middle of 1990s in major cities of China suggests that it is important to detect the intrauterine hypoxemia as it may indicated by meconium staining amniotic fluid which should be intervened early by adequate termination of pregnancy before 42 weeks. The effects of delivery room suction and conventional ventilation also need to be reevaluated.

Scientific Evidence about the Assistance Provided to the Newborn with Meconium Elimination:Integrative Literature Review

The Meconial Aspiration Syndrome (MAS) is a complication caused by the presence of meconium amniotic fluid with consequent aspiration, being responsible for important rates of perinatal morbidity and mortality. This study aims to analyze the bibliographical production on newborn care with meconium elimination in the delivery room. It was a literature integrative review electronically based. Most of the studies referred to tracheal intubation and exogenous surfactant ministration as main care methods. The Meconium Aspiration Syndrome is presented as main theme. It is understood that health care professionals must develop knowledge, skills and actions, showing conduct based on scientific, critical and reflexive knowledge with purposeful interventions directed to the patient’s needs.