The Outcome Of Meconium-Stained Liquor In Newborn In A Tertiary Care Hospital

Abstract

Background: Amniotic fluid is the fluid that surrounds the fetus inside the womb and creates a safe, protective, and impact-free environment. Meconium enters the amniotic fluid when the fetus is stressed. Its existence indicates prenatal dysfunction and is linked to higher perinatal morbidity and mortality. Our aim of this study was to determine the perinatal outcome of meconium-stained amniotic fluid babies born in a tertiary care center.

Materials and Methods: This is a retrospective study done in Tertiary Care Hospital in Tamil Nadu, India and data were collected from the period of 24 months from 2020-2022. A total of 112 patients were included in the study and their case sheets were analyzed. Neonates from the postnatal ward and Neonatal Intensive Care Unit (NICU) admitted with meconium-stained liquor were included in the study. Maternal factors as well as neonatal factors were analyzed. Neonatal factors like Birth asphyxia, Requirement of NICU admission, oxygen requirement, development of meconium aspiration syndrome, neonatal sepsis, Development of PPHN, Inotrope requirement and sildenafil requirement were also analyzed. The neonatal factors were compared to find the outcome of neonates with meconium-stained liquor.

Results: The mean maternal age were 28.7 years and Mean weight of the neonates was 3kgs. 35.7% were Male neonates and with female predilection of 64.3%. Maternal complications were also analyzed. Pregnancy Induced Hypertension (PIH) was seen in 16, Gestational Diabetes Mellitus was seen in 17 and Anemia was seen in 11. Meconium was thin in 95 neonates and thick in 17 neonates. Premature rupture of membrane was seen in 94 neonates. Factors like Identity of the neonate, Gestational age, Gender of the neonate, Maternal age, maternal booking, parity and pregnancy complications and comorbidities, Mode of delivery, Birth weight of the neonate, Apgar score, Neonatal outcomes such as Birth asphyxia, Requirement of NICU admission, oxygen requirement, development of meconium aspiration syndrome, neonatal sepsis, Development of PPHN, Inotrope requirement or sildenafil requirement, Comorbidities of neonate were compared to the meconium stained Amniotic fluid in neonates. It was noticed that the neonatal factors like birth asphyxia seen in 17; requirement of oxygen among 25 neonates, development of sepsis and requirement of antibiotics 15 and 14 respectively among the neonates had significant association with the outcome of the neonates with meconium aspiration syndrome.

Conclusion: Meconium-stained amniotic fluid is associated with an increased frequency of operative deliveries, poor neonatal outcomes, and more frequent admissions to the NICU. Identification of high-risk factors is important, and timely referral of patients to centers with appropriate neonatal care facilities equipped with mechanical ventilators reduces neonatal morbidity and mortality. In this study, It was noticed that the neonatal factors like birth asphyxia seen in 17, requirement of oxygen among 25 neonates, development of sepsis and requirement of antibiotics 15 and 14 respectively among the neonates had significant association with the outcome of the neonates with meconium aspiration syndrome.