Article Text

MECONIUM-STAINED AMNIOTIC FLUID, MECONIUM ASPIRATION SYNDROME: ARE WE ABLE TO MAKE A DIFFERENCE IN THE MANAGEMENT?
  1. S A Alsaad1
  1. 1NICU, Department of Pediatrics, Aljahra Hospital, Kuwait

Abstract

Introduction Meconium-stained amniotic fluid (MSAF) results from the passage of fetal colonic contents into the amniotic cavity. It is noted in 12% of pregnancies. Meconium aspiration syndrome (MAS) is noted in 5% of these infants. The delivery room management of infants born through (MSAF) remains an issue for debate among neonatologist and obstetricians.

Setting Neonatal Unit of Aljahra Hospital.

Subjects 1610 consecutive deliveries, over a 15 month period. Interventions: in all babies born through MSAF, thorough oropharyngeal suction as soon as the head was delivered followed by immediate intratracheal intubation and suctioning in infants depressed at birth.

Results 93 (5.77%) deliveries had MSAF other studies have reported incidence varying between 7–22% of live births. Fetal distress during labor and intrauterine growth retardation were observed with MSAF. 15 (16.1%) babies developed MAS needed intubations and ventilation The consistency of meconium did not have a direct bearing on the neonatal outcome. no deaths were observed, however, morbidities i.e. convulsions, DIC, needing HFOV were observed in 4 babies.

Conclusions A selective approach can be adopted for babies with MSAF reserving intratracheal suctioning at birth for depressed neonate or evidence of fetal distress in utero. Other neonates only need careful observation after thorough oronasopharyngeal suctioning.

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