Clinical Profile and Outcome of Meconium-Stained Babies Managed in a Tertiary Care Hospital

Objectives: This study evaluates clinicopathological features and the outcome of meconium-stained babies managed in the special care baby unit of Dhaka Medical College Hospital (DMCH), a tertiary care hospital in Bangladesh. Methods: This observational study was performed in DMCH from 1st March to 31st October 2011. One hundred two neonates with meconiumstained amniotic fluid (MSAF) at birth were selected purposively. Information about the duration of labour, mode of delivery, maternal illness, and maternal medication during pregnancy were recorded. Any other complications like obstructed labour, history of premature rupture of membrane (PROM), history of less fetal movement, history of birth asphyxia were taken from parents and available medical records. Babies’ clinical conditions were assessed with APGAR score, birth weight, gestational age, signs of asphyxia, respiratory difficulties, convulsion, reflex activity and requirement of resuscitation, percentage of oxygen saturation, capillary blood glucose (CBG). Other related investigations were also recorded. The outcome of these babies was observed and recorded. Statistical analysis (Chi-square tests) was performed on the recorded data using SPSS (version 24) to identify the association between meconium staining and different clinical features of the newborn. Results: Among the 102 neonates, we found 39 (38.2%) cases of only meconium staining, 56 (54.9%) cases of staining with ingestion, and 7 (6.9%) cases of staining with aspiration. Only meconium-stained cases were relatively well alert with normal vital parameters. Other cases of ingestion and aspiration developed complications, such as birth asphyxia, aspiration pneumonia, meconium aspiration syndrome and hypoxicischemic encephalopathy, septicemia. 7.84% of the studied 102 cases died, who were mainly from the aspiration group. Conclusion: This study found that meconium-stained babies’ prominent clinical features are breathing difficulties, hypoxic-ischemic encephalopathy, features of sepsis, features of pneumonia, and meconium gastritis. Hospitalization was needed in 97.06% of cases, and 7.8% of cases died due to associated complications.