A 3-year review of meconium aspiration syndrome.

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.