To study prevalence of persistent pulmonary hypertension in newborn with meconium aspiration syndrome in western Rajasthan, India: a prospective observational study

Aim: To study the prevalence of persistent pulmonary hypertension (PPHN) in newborn with meconium aspiration syndrome (MAS) in western Rajasthan, India.Material and methods: Hundred full-term newborns who had features of MAS at birth were included in this survey and were evaluated for PPHN using laboratory investigations, including pulse oximetry, ABG, chest X-ray, ECG and 2D color echocardiography.Results: Nineteen neonates showed PPHN, of them 16 had a shunt reversal at PFO level and the rest at PDA level. Most of these newborns were delivered by emergency cesarean section and were unplanned. A majority of neonates of PPHN (84.21%) were diagnosed within 48h of life and 73.69% had Downey's score more than 6. Neonates of PPHN had mean PH 7.210.07, mean PCO2 53.73 +/- 6.8, mean PaO2 61.10 +/- 10.61 and mean PaO2/FiO(2) 144.03 +/- 46.31.Conclusions: PPHN is a genuine problem in MAS-born neonates and is commonly seen in neonates born by unplanned and unmonitored delivery, and the prevalence of PPHN can be reduced by providing good antenatal care, regular follow up of high-risk pregnancy. 2D echocardiography is an important point of care in the diagnosis of PPHN in nursery and should be promoted in nurseries of developing countries as being engaged in developed countries for more reliable treatment.