Incidence of meconium aspiration syndrome in term meconium-stained babies managed at birth with selective tracheal intubation

Manganaro, R; Mamì, C; Palmara, Antonella; Paolata, Antonina; Gemelli, Marina

doi:10.1515/jpm.2001.065

Cited by 25 publications

(13 citation statements)

References 13 publications

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“…Some studies suggested that prevention of postterm pregnancy prevents severe MAS [33]. The earlier induction of labour (e.g., by 41 weeks) may prove to be beneficial for the prevention of the MAS as shown by Ross [34].…”

Section: Discussionmentioning

confidence: 99%

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A Population-Based Study of Meconium Aspiration Syndrome in Neonates Born between 37 and 43 Weeks of Gestation

Fischer

Rybakowski

Ferdynus

et al. 2012

International Journal of Pediatrics

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The epidemiology of meconium aspiration syndrome (MAS) in term neonates is described in a population-based retrospective study of data recorded for all births from 2000 to 2007 in a French region (Burgundy). Of the 132 884 eligible term newborns, the rate of meconium-stained amniotic fluid (MSAF) was 7.93%. The prevalence of severe MAS was 0.067% in the overall population. MAS rate was 0.11% at 37-38 weeks of gestation (WG), 0.20% at 39–41 WG, and 0.49% at 42-43 WG. Factors independently associated with severe MAS were identified by a case-control study, that is, thick meconium amniotic fluid, fetal tachycardia, Apgar score ≤3 at 1 minute, and birth in a level III facility. Our results confirm the high prevalence of MSAF after 37 WG but also show the low frequency of severe MAS in a period corresponding to the new international recommendations on the management of birth with MSAF.

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Section: Discussionmentioning

confidence: 99%

“…Nowadays, identification of perinatal asphyxia remains a major endpoint of MAS prevention [33]. Guidelines of earlier fetal monitoring (e.g., by 40 WG) proved to be beneficial for the prevention of MAS [34].…”

Section: Discussionmentioning

confidence: 99%

A Population-Based Study of Meconium Aspiration Syndrome in Neonates Born between 37 and 43 Weeks of Gestation

Fischer

Rybakowski

Ferdynus

et al. 2012

International Journal of Pediatrics

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show abstract

“…[107][108][109][110][111][112][113][114][115][116] Appropriate intervention to support ventilation and oxygenation should be initiated as indicated for each individual infant. This may include intubation and suction if the airway is obstructed.…”

Section: 8mentioning

confidence: 99%

Part 13: Neonatal Resuscitation

Wyckoff¹,

Aziz²,

Escobedo³

et al. 2015

Pediatrics

265

353

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“…For the critical outcome of mortality and/or MAS, we identified evidence from 9 very-low-quality observational studies [158][159][160][168][169][170][171][172][173] demonstrating no improvement in survival and/or incidence of MAS (including depressed and/or vigorous infants) when infants born through MSAF were intubated for tracheal suctioning (downgraded for indirectness).…”

Section: Perlman Et Al Part 7: Neonatal Resuscitation S219mentioning

confidence: 99%

Part 7: Neonatal Resuscitation

Perlman¹,

Wyllie²,

Kattwinkel³

et al. 2015

Circulation

525

256

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The transition from intrauterine to extrauterine life that occurs at the time of birth requires timely anatomic and physiologic adjustments to achieve the conversion from placental gas exchange to pulmonary respiration. This transition is brought about by initiation of air breathing and cessation of the placental circulation. Air breathing initiates marked relaxation of pulmonary vascular resistance, with considerable increase in pulmonary blood flow and increased return of now-welloxygenated blood to the left atrium and left ventricle, as well as increased left ventricular output. Removal of the lowresistance placental circuit will increase systemic vascular resistance and blood pressure and reduce right-to-left shunting across the ductus arteriosus. The systemic organs must equally and quickly adjust to the dramatic increase in blood pressure and oxygen exposure. Similarly, intrauterine thermostability must be replaced by neonatal thermoregulation with its inherent increase in oxygen consumption.Approximately 85% of babies born at term will initiate spontaneous respirations within 10 to 30 seconds of birth, an additional 10% will respond during drying and stimulation, approximately 3% will initiate respirations after positive-pressure ventilation (PPV), 2% will be intubated to support respiratory function, and 0.1% will require chest compressions and/or epinephrine to achieve this transition. [1][2][3] Although the vast majority of newborn infants do not require intervention to make these transitional changes, the large number of births worldwide means that many infants require some assistance to achieve cardiorespiratory stability each year.Newly born infants who are breathing or crying and have good tone immediately after birth must be dried and kept warm so as to avoid hypothermia. These actions can be provided with the baby lying on the mother's chest and should not require separation of mother and baby. This does not preclude the need for clinical assessment of the baby. For the approximately 5% of newly born infants who do not initiate respiratory effort after stimulation by drying, and providing warmth to avoid hypothermia, 1 or more of the following actions should be undertaken: providing effective ventilation with a face mask or endotracheal intubation, and administration of chest compressions with or without intravenous medications or volume expansion for those with a persistent heart rate less than 60/min or asystole, despite strategies to achieve effective ventilation (Figure 1).The 2 vital signs that are used to identify the need for an intervention as well as to assess the response to interventions are heart rate and respirations. Progression down the algorithm should proceed only after successful completion of each step, the most critical being effective ventilation. A period of only approximately 60 seconds after birth is allotted to complete each of the first 2 steps, ie, determination of heart rate and institution of effective ventilation. Subsequent progression to the next step will depend o...

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Incidence of meconium aspiration syndrome in term meconium-stained babies managed at birth with selective tracheal intubation

Cited by 25 publications

References 13 publications

A Population-Based Study of Meconium Aspiration Syndrome in Neonates Born between 37 and 43 Weeks of Gestation

A Population-Based Study of Meconium Aspiration Syndrome in Neonates Born between 37 and 43 Weeks of Gestation

Part 13: Neonatal Resuscitation

Part 7: Neonatal Resuscitation

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