CLINICAL OUTCOMES OF NEONATES WITH MECONIUM ASPIRATION SYNDROME IN A TERTIARY CARE CENTRE: A PROSPECTIVE OBSERVATIONAL STUDY

Abstract

Meconium aspiration syndrome (MAS) remains a major cause of neonatal respiratory distress, occurring in 5% of infants born through meconium-stained amniotic fluid (MSAF). It is linked to fetal distress and can lead to significant lung and cardiac complications. Early identification of risk factors and outcomes is essential for improving neonatal survival.

Methods: A prospective observational study was conducted in the neonatal intensive care unit of a tertiary care center over three years (June 2019–December 2022). MAS was diagnosed based on respiratory distress in neonates born through MSAF using criteria mentioned in Cloherty and Stark’s manual of neonatal care. A total of 77 term and post-term neonates diagnosed with MAS were included. Clinical characteristics, antenatal risk factors, complications, radiological findings, and outcomes were analyzed.

Results: Out of 77 neonates, 61% were born to primigravida mothers. Pregnancy-induced hypertension was the most common antenatal risk factor (20.7%). Common complications included septic shock (40.25%), followed by respiratory distress (24.67%), and birth asphyxia (23.37%). Atelectasis was the most frequent radiological finding (33.7%). Mechanical ventilation was required in 20.8% cases. Overall survival rate was 88.3%, with mortality rate of 11.7%

Conclusion: MAS is associated with significant neonatal morbidity, particularly septic shock and respiratory complications. Antenatal care with prevention and treatment of maternal risk factors, intrapartum assessment of fetal distress and use of proper aseptic techniques during delivery & resuscitation and then transport of the baby to referral centre help in reducing morbidity and mortality in MAS neonates. After birth, timely diagnosis and provision of proper respiratory support by assessment of the severity of distress can prevent the mortality and morbidity due to MAS.