Abstract
Abstract
Objective: To evaluate if Downes– Vidyasagar score (Downes score) for assessing respiratory distress could be used to determine the duration for observation and requirement for investigations like chest X-ray and blood gases, in an infant born through meconium stained amniotic fluid (MSAF).
Materials and Methods: Prospective observational study was done in 2 phases—the initial phase to assess the role of the Downes score and the second phase to assess if the conclusions drawn from the initial phase could be applied in clinical practice.
Results: In the initial phase, a total of 285 of the 302 infants born through MSAF were included for assessing the role of Downes score. The score reduced with time and did not worsen beyond 6 h. A significant association was noted between Downes score 2 or more at beyond 6 h of life and umbilical cord pH 7.15, higher AaDO2, and chest X-ray suggestive of meconium aspiration syndrome (MAS). In the second phase, applying the criteria of clinical monitoring derived from the initial phase resulted in 75% (110/147) of infants born through MSAF being shifted to the mother’s side by 6 h of life without being subjected to any investigation,
Conclusion: Radiological evaluation and blood gas analysis could be restricted to only infants with persistently high or rising Downes score beyond 6 h of life. Infants having a score of <2 by 6 h of life can be shifted to mother’s side, without any further investigations or interventions.
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