A 3-year review of meconium aspiration syndrome

Abstract

Aim of study: To review the incidence, morbidity and mortality of Meconium Aspiration Syndrome (MAS). To identify possible predictors of MAS in newborns with thick meconium-stained amniotic fluid (MSAF) at delivery.

Methodology: Case records of babies with MSAF delivered in Singapore General Hospital from 1.1.1991 to 31.12.1993 were studied retrospectively.

Results: In the study period, 1,893 babies (15% of live births) had MSAF and 174 babies (1.4% live births) developed MAS. The incidences of MAS in newborns with light, moderate and thick MSAF were 0.3%, 5.8% and 61% respectively. Complications associated with MAS were metabolic acidosis (52%), air leak syndrome (2%), persistent pulmonary hypertension (2%) and hypoxic ischaemic encephalopathy (0.5%). The mortality rate of babies with MAS was 2%. Newborns with thick MSAF were more likely to develop MAS if they were males, small-for- gestational-age, had fetal distress and meconium was sucked from the trachea at birth.

Conclusion: Vigilant perinatal monitoring of high risk babies with MSAF and proper resuscitation at birth would help reduce the incidence of MAS and its associated complications.