Evaluation and management of neonates with meconium stained amniotic fluid

The purpose of this study was to evaluate neonates with meconium stained amniotic fluid and to investigate whether pulmonary disease and mortality were significantly greater in infants with thick meconium. Method: We evaluated 278 meconium stained neonates between January 1993 ? February 1999. Amniotic fluid was defined as thin (221 neonates) or thick (57 neonates) by a pediatrician. Results: Compared to neonates with thin meconium, those with thick meconium appeared to have significantly greater rates of acidemia, low APGAR scores at the 1th and 5th minutes, more need for resuscitation and higher mortality rate. Meconium aspiration syndrome and hypoxic ischemic encephalopathy were also significantly higher in infants with thick meconium. Conclusion: Amniotic fluid with thick meconium may cause more respiratory and other complications in neonates than amniotic fluid with thin meconium. Therefore, tracheal suction is recommended for infants born depressed and with thick meconium stained amniotic fluid.