Morbidity and mortality of neonates associated with meconium stained liquor in labour

Abstract

INTRODUCTION: Few prospective studies have been performed in Sri Lanka to determine the morbidity and mortality of neonates associated with meconium stained liquor at delivery (MSLD) and rneconium aspiration syndrome (MAS) OBJECTIVES: 1. Determine the incidence, morbidity and mortality of MSLD. 2. Determine the differences in the outcome of babies who had meconiurn above and below the vocal cords. 3. Determine whether foetal heart sound (FHS) and CTG (cardio-tocography) are predictive of MSLD and MAS. METHOD: A prospective study of 77 babies with MSLD at the Professorial Units, Teaching Hospital, Ragama, during a four month period was done. 68 were examined by the PHO with a laryngoscope to detect meconium above or below the vocal cords. All babies were kept under observation for signs of MAS. Respiratory rate, oxygen saturation, CXR changes were recorded, RESULTS: Of 1447 live births 77 (5.3%.) had MSLD, 35 were admitted to a SCBU and 11 (31,41%.) developed MAS. There were 2 deaths (16.7%). 4/58 (6.891%.) with meconium above the vocal cords had MAS compared to 7/10 (70%.) babies who had meconium below the vocal cords (P<0. 001). CTG abnormalities were seen in 13/50 (20%) babies with MSLD, and 3/11 (27,7%) babies with MAS. .FHS abnormalities were seen only in 9/77 (11.87%) babies with MSLD; out of this 2 (22.2%) had MAS. 68/77 (88%) MSLD had regular FHS and 9/1 1 (8 1 %) babies with MAS had regular FHS. CONCLUSIONS: The incidence of MAS following MSLD is low. Meconium below the vocal cords was associated with poor prognosis. FHS and CTG abnormalities were not predictive of MSLD or MAS.