The incidence and clinical features of meconium aspiration syndrome: a two-year neonatal intensive care experience

Year 2019, Volume: 5 Issue: 5, 776 - 780, 04.09.2019

Atiye Fedakar

https://doi.org/10.18621/eurj.419427

Abstract

Objectives:
The aim of this present study was to review the
clinical characteristics, risk factors, frequency of meconium aspiration syndrome
(MAS), development and maternal demographic characteristics of the newborns
born with meconium stained amniotic fluid (MSAF) in our neonatal intensive care
unit.

Methods: The
files of the patients hospitalized in our neonatal intensive care unit between
July 31, 2015 and July 31, 2017 and who were diagnosed with MAS or MBAS were
examined retrospectively.

Results: A
total of 1410 patients were included during this period. Of these patients, 98
were term infants and 3 (34 weeks) were preterm infants. One hundred and one
infants (7.1%) had MSAF and/or MAS. Of the patients, 63 were boys, 38 were
girls. MAS developed in 61 patients (60.3%) who were hospitalized due to MBAS.
No difference was detected between two groups in terms of the systemic
diseases, age, pregnancy number, gestation week, delivery type, length of hospital
stay of mother and birth weight of infant. The fifth minute Apgar score and
need for resuscitation were found to be statistically significant in patients
with MAS. We did not have any mortality.

Conclusion: MAS frequency decreases
in parallel with the developments in neonatal care but  it is still a major cause of mortality and
morbidity. We believe that chance of mortality and morbidity will decrease
thanks to the close follow-up and early treatment in infants born with MSAF who
are likely to develop MAS. 

Keywords

Meconium aspiration syndrome, meconium stained amniotic fluid, newborn

References

• [1] Khazardoost S, Hantoushzadeh S, Khooshideh M, Borna M. Risk factors for meconium aspiration in meconium stained amniotic fluid. J Obstet Gynaecol 2007;27:577-9.
• [2] Toptan HH, Karadağ N, Karatekin G. [Meconium aspiration syndrome and innovation in the approach]. Zeynep Kamil Tıp Bülteni 2016;47:4;132-8. [Article in Turkish]
• [3] Çetin H, Altın H. [Meconium aspiration syndrome]. Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi 2006;13:42-6. [Article in Turkish]
• [4] Pulmonary Diseases. In: Neonatology. Gomella TL, Cunningham MD, Eyal FG, Zenk KE. Eds., 4th, Appleton&Lange. 1999:pp. 506-10.
• [5] Uslu S, Dursun M, Bülbül A. [Meconium aspiration syndrome]. Şişli Etfal Hastanesi Tıp Bülteni 2015;49:85-95. [Article in Turkish]
• [6] Wiswell TE, Bent RC. Meconium staining and the meconium aspiration syndrome. Unresolved issues. Pediatr Clin North Am 1993;40:955-81.
• [7] Yuksel B, Greenough A, Gamsu HR. Neonatal meconium aspiration syndrome and respiratory morbidity during infancy. Pediatr Pulmonol 1993;16:358-61.
• [8] Fanaroff AA. Meconium aspiration syndrome: historical aspects. J Perinatol 2008;28:3-7.
• [9] Xu H, Calvet M, Wei S, Luo ZC, Fraser WD. Amnioinfusion Study Group. Risk factors for early and late onset of respiratory symptoms in babies born through meconium. Am J Perinatol 2010;27:271-8.
• [10] Bhat RY, Rao A. Meconium-stained amniotic fluid and meconium aspiration syndrome: a prospective study. Ann Trop Paediatr 2008;28:199-203.
• [11] Akar M. Perinatal asfiksi. İçinde: Dilmen U (ed). Yenidoğan Rehberi: Sarıyıldız Ofset, 2010:pp. 354-56.
• [12] Karatekin G, Kesim Dönmez M, Nuhoğlu A. Risk factors for meconium aspiration syndrome. Int J Gynecol Obstetr 1999;65:295-7.
• [13] Walsh MC, Fanaroff JM. Meconium stained fluid: approach to the mother and the baby. Clin Perinatol 2007;34:653-65.
• [14] Vain NE, Szyld EG, Prudent LM, Aguilar AM. What (not) to do at and after delivery? Prevention and management of meconium aspiration syndrome. Early Human Dev 2009;85:621-6.
• [15] David AN, Njokanma OF, Iroha E. Incidence of and factors associated with meconium staining of the amniotic fluid in a Nigerian University Teaching Hospital. J Obstet Gynaecol 2006;26:518-20.
• [16] Peng TC, Gutcher GR, Van Dorsten JP. A selective aggressive approach to the neonate exposed to meconiumstained amniotic fluid. Am J Obstet Gynecol 1996;175:296-301.
• [17] Dargaville PA, Copnell B; Australian and New Zealand Neonatal Network. The epidemiology of meconium aspiration syndrome: incidence, risk factors, therapies, and outcome. Pediatrics 2006;117:1712-21.
• [18] Van Ierland Y, de Boer M, de Beaufort AJ. Meconiumstained amniotic fluid: discharge vigorous newborns. Arch Dis Child Fetal Neonatal Ed 2010;95:69-71.
• [19] Espinheira MC, Grilo M, Rocha G, Guedes B, Guimarães H. Meconium aspiration syndrome-the experience of a tertiary center. Rev Port Pneumol 2011;17:71-6.
• [20] Şen V, Karabel M, Uluca Ü, Ağaçayak E, Tan İ, Karabel D, et al. [The evaluation of newborns with meconium aspiration syndrome in neonatal intensive care unit]. Van Tıp Dergisi 2014;21:230-5. [Article in Turkish]
• [21] Manganaro R, Mami C, Palmara A, Paolata A, Gemelli M. Incidence of meconium aspiration syndrome interm meconium-stained babies managed at birth with selective tracheal intubation. J Perinatal Med 2001;29:465-8.
• [22] Wiswell TE. Handling the meconium-stained infant. Semin Neonatol 2001;6:225-31.
• [23] El Shahed AI, Dargaville PA, Ohlsson A, Soll R. Surfactant for meconium aspiration syndrome in term and late preterm infants. Cochrane Database Syst Rev 2014;14;12.
• [24] Singh BS, Clark RH, Powers RJ, Spitzer AR. Meconium aspiration syndrome remains a significant problem in the NICU: outcomes and treatment patterns in term neonates admitted for intensive care during a ten-year period. J Perinatol 2009;29:497-503.
• [25] Özdemir R, Akçay A, Dizdar EA, Oğuz ŞS, Yurttutan S, Yapar EG, et al. [The incidence and prognostic factors in meconium aspiration syndrome: one-center experience]. Çocuk Sağlığı ve Hastalıkları Dergisi 2011;54:211-15. [Article in Turkish]
• [26] Choi W, Jeong H, Choi SJ, Oh SY, Kim JS, Roh CR, et al. Risk factors differentiating mild/moderate from severe meconium aspiration syndrome in meconium-stained neonates. Obstet Gynecol Sci 2015;58:24-31.
• [27] Kırımi E. [Meconium aspiration syndrome]. Turkiye Klinikleri J Pediatr Sci 2013;9:25-33. [Article in Turkish]