MECONIUM ASPIRATION SYNDROME , RISK FACTORS
AbstractBackground and Objective : The presence of meconium in the amniotic fluid is regard as abnormal and both the obstetrician and pediatrician must be alerted to possible fetal or neonatal complication and presence of meconium in trachea may lead to meconium aspiration syndrome ( MAS) . Method : A prospective study was conducted on 155 symptomatic meconium aspiration babies. The information of studay depend on clinical observation at intensive neonatal care unit and delivery room notes. Results : Meconium stained amniotic fluid ( MSAF) is found in (4.8%) of total deliveries and usually in term (78%) , posterm (16%) and (6 % ) preterm . The incidence of MAS among meconium stained (18.4 %) . Birth asphyxia, maternal toxaemia and breech presentation were significant risk factors for severity of MAS and not only risk factors for MAS. Most of babies had low apgar score at one minute, and thick meconium was associated with lower apgar score and C.S added more to the problem. Male affacted little more than female and immediate oropharynx suction was very valuable in reducing mortality rate ( M.R) from 14% to 6 % . (9) babies of MAS died ( 5.8%) because of recurrent seizure , respiratory failure and asphyxia. Conclusions: MAS is still a great problem in our locality causing a lot of morbidity and mortality. Immediate intervention and oropharynx suction was very beneficial in reducing M.R.
Hobel C.J , Bocher C : Meconium staining of Amniotic Fluid. In : Assessment and Care of the Fetus ( physiological, chemical and medicological principle ). Eden R. D, Frank H.B , international (ed). 1999 : 801 – 9
Barbara J. Stoll , Ira Adams. Champman : Delivery room emergencies. In : Nelson Textbook of Pediatrics. Behrman R.E, Kliegman R.M . 18th ed. 2007: 742-3 .
Neil Mcintosh, Ben Stenson : The newborn in: Forfar and Arneils Textbook of Pediatrics. Neil Mcintosh, Peter Helms 7th ed . 2008 : 253 – 3 .
Richard A., Chrenkranz : The newborn intensive care unit . In : Oski's Pediatrics. Jalia A. Memillan, Ralph D. Feigin . 4th ed., 2006 : 211
Elizabeth L. Raab, Lisa K. Kelly: Neonatal respiratory failure. In : Roger's Textbook of Pediatrics intensive care. David G. Nichols, 4th ed . 2008: 706-7 .
Ostrea E.M., Nagvi M: The Influence of Gestational Age On the Ability of the Fetus to pass Meconium in Utero. Acta Obstet . Gynecol. Scand. 1992, Vol. 61, pp 272 -7.
Clarence W. Gowen : Fetal and neonatal medicine. In : Nelson Essential of Pediatrics. Ropert M. K;iegman , Karen J. Marcdante. 5th ed. , 2006 : 279.
James J. Cummings: Neonatal Resuscitation. In : Pediatric Hospital Medicine. Ronald M. Perken, James D. Swift. 2nd . 2008 : 855 .
Ian Cross: Respiratory system. In : Oski's Essential Pediatrics . Michael Crocetti, Michael A. Barone. 2nded . 2004: 47.
Elizabeth H. Thilo, Adam A. Rosenberg: The newborn infant . in : Current diagnosis and treatment . William W. Hay, Jr. Myron J. Levin , 19th ed , 2008 : 29 .
Miller F.C ., Sacks D.A., Paul R.H: Significance of Meconium During Labour . Am.J. Obstet. Gynecol. 1995 July; Vol. 122, No. 5 : 573 – 79 .
Suhas M. Nafday, : Neonatal Medical condition In: Textbook of Pediatric care. Thomas K. Mc Inerny, Henry M. Adam. 1st ed. 2009 : 908 – 9 .
Collin S. Goto , Brain A. Bates: Resuscitation of the newborn infant. In: Pediatric Emergency Medicine. Cary R. Strange , Willliam R. Ahrens. International ed . 2004: 22 .
Yong – yp; Ho-Ly: A 3 – year review of meconium aspiration syndrome. Singapore – J . 1997 May ; 38 (5) : 205-8 .
Philip N. Baker , Neonatology. In : Obstetrics by ten teachers, 18th ed., 2006 : 322 – 3 .
Elizabeth L. Raad : The resuscitation and care of the newborn at risk in: Current Diagnosis and Treatment . Alan H. Dechnerney , T. Murphy Goodwin , 2007 : 502 – 3.
Weismiller – DG: Transcervical Amnioinfusion Am- Fam. Physician . 1998 feb ; (3) : 504 -10 .
Moodley – J., Matchaba – P . Pagne – AJ: Intra partum Amnioinfusion for Meconium .Stained ligour in developing countries. Trop. Doct. 1998 Jan ; 28(1) : 3 – 4.
Surbek – DV; Hosli – IM ; pavic – N . Transcervical Intrapartum Amnioinfusion : Asimple and effective Technique. Eur-J- Obstel . Gynecol – Reprod- Biol. 1997 , Dec, 75 (2) : 123 – 6 .
Khoasla – A- H ; Sangwan – K ; Ahuja – SD ; Prophylactic Amnioinfusion During labour complicated by Meconium . Aust – N- 2 – J – Ostet . gynecol. 1997 Aug. 937 (3): 294-7
Alan W. Ducan : Acute Respiratory Failure in children. In: OH's Intensive care Manual .And Drew D. Bersten, Neil Soni. 2009: 1104 .
Coltart. T.M ., Byrne D.L ., Bates S.A : Meconium Aspiration A6 year Retrospective study. British J. Obstet . Gynecol . 1999 April , vol . 96 : 411-14.
M.A. Thomson , A.D . Edwards. Neonatal care for Obstetrician . In : Dew hursti Text book of Obstet. Gynecol. Keith Edward. 7th ed . 2007 : 87.
Urbaniak – K.J; Mc Cowan ; Townened – KM : Risk factors for Meconium Aspiration syndrome – Aust – N- 2-J – Obstet – Gynecol. 1996 Nov, 36 (4) : 4016.
Morava – E ., Gill – W ; Pierce – M : ECMO in Neonatology : Review of the use of the method. Oru – Hetil. 1998 Feb 22 ' 139