BCC Lam, WK To, CY Yeung

Abstract

This is a prospective study of the perinatal characteristics of 427 consecutive infants who were born with meconium stained amniotic fluid (MSAF). They were managed by combined obstetric and paediatric suctioning of the airways at birth. The incidence of meconium aspiration syndrome (MAS) was 11 500 of infants born with MSAF. Meconium aspiration syndrome (n=49) especially severe MAS (n=6) were more likely to occur in several conditions, viz (1) liquor was thickly meconium-stained, (2) infant was apnoeic before intubation suctioning, (3) infant with lower apgar score at 5 minutes and (4) infants who needed intermittent positive pressure ventilation for resuscitation at birth. Among 49 infants with meconium aspiration syndrome most recovered well. Fourteen infants (28.5%) required oxygen supplement, six (12%) required mechanical ventilation and eight (18%) developed air leak complication. Four (8%) progressed to persistent pulmonary hypertension as confirmed by echocardiogram. Identification of perinatal risk factors associated with MAS may enable close monitoring and early intervention.