Risk Factors for Meconium‐Aspiration Syndrome

Abstract

The aim of this retrospective study was to identify risk factors for meconium-aspiration syndrome, and to identify antenatal and intrapartum risk factors which might be preventable. We analyzed maternal and neonatal records of the 210 infants who had meconium-stained liquor and who also developed respiratory distress necessitating admission to the Special Care of Intensive Care Baby Units at National Women's Hospital, Auckland in 1992. Meconium-aspiration syndrome occurred in 6.6% of meconium exposed babies and in 1.3% of total births. Severe meconium-aspiration syndrome developed in 18 infants, moderate in 48, mild in 60 respiratory distress in 84. An association was found between meconium aspiration syndrome and primiparity (p = 0.001) and Pacific Island ethnicity (p = 0.0002). An association was also found between the severity of meconium and low umbilical artery pH (p = 0.0002). Thick meconium and an abnormal cardiotocograph were more common in severe meconium-aspiration syndrome. All deaths and long-term morbidity occurred in babies with abnormal cardiotocographs or in unmonitored infants. Preventable antenatal and intrapartum factors were not identified in this study.

Síndrome de aspiração 7 do mecônio: análise de resultados obstétricos e perinatais

“…Urbaniak et al 8 objetivaram identificar fatores de risco para a SAM nos períodos antenatal e intraparto que pudessem ser prevenidos; para tal, analisaram 210 neonatos que apresentaram mecônio no líquido amniótico e que desenvolveram distúrbios respiratórios no pós-parto imediato. A incidência de SAM foi de 6,6% em crianças expostas ao mecônio, e de 1,3% na população geral de nascimentos.…”

“…Urbaniak et al (1996) 8 encontraram associação significante entre a SAM e a primiparidade. Usta et al (1995) 10 relataram que o tabagismo esteve relacionado com riscos mais baixos de SAM.…”

Obstetric approaches to the prevention of meconium aspiration syndrome

“…Those factors are heavy MSAF, nulliparity, postterm delivery, fetal heart rate (FHR) abnormalities during labor, presence of meconium below the vocal cords, cesarean delivery and the low Apgar scores. 13,14,20,[25][26][27][28][29][30] It has been reported that there is an apparent relationship between maternal ethnicity and risk of MSAF, and the risk of MAS having been observed to be increased in black Americans, Africans and Pacific Islanders. [30][31][32] Intrapartum fetal monitoring The goal of continuous electronic fetal heart rate monitoring (EFM) is to detect fetal hypoxemia and therefore reduce the risk of adverse neonatal outcomes.…”

“…1,[12][13][14] The case fatality rate of MAS has been reported to be high, ranging from 5 to 40%. 1,[13][14][15][16][17] Approximately one-third of babies with MAS require intubation and mechanical ventilation, and other new therapies such as high frequency ventilation, inhaled nitric oxide and surfactant administration, although the effectiveness of certain of these technologies remain controversial. 2,[17][18][19] Serious complications resulting from MAS include pneumothorax, convulsion and death.…”

Intrapartum amnioinfusion for meconium‐stained amniotic fluid: a systematic review of randomised controlled trials

“…MAS has been reported to occur in 6.6-30% of cases complicated with MSAF and in 1-3% of liveborn infants. [7][8][9] The case fatality rate of MAS has been reported to be high, ranging from 5 to 40%. 8,[10][11][12] Amnioinfusion (AI), or transcervical infusion of saline into the amniotic cavity, has been proposed as a method to reduce MAS.…”