Predictors of mortality in neonates with meconium aspiration syndrome

Louis, Deepak; Sundaram, Venkataseshan; Mukhopadhyay, Kanya; Dutta, Sourabh; Prabhash, Kumar

doi:10.1007/s13312-014-0466-0

Cited by 39 publications

(57 citation statements)

References 13 publications

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“…80 In a recent trial from India, mortality rate was found to be as high as 26%, with lower birth weight, the presence of myocardial dysfunction, and higher initial oxygen requirement being independent predictors of mortality. 81 Approximately, one third of these deaths in MAS are directly attributable to pulmonary cause, with the remainder being ascribed to accompanying hypoxic ischemic encephalopathy.…”

Section: Future Therapymentioning

confidence: 99%

Meconium aspiration syndrome: challenges and solutions

Goel¹,

Nangia²

2017

RRN

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Meconium aspiration syndrome (MAS) is an important cause of morbidity and mortality among term newborns. A result of antepartum or postpartum aspiration of meconium stained amniotic fluid (MSAF), MAS causes respiratory distress of varying severity, often complicated by air leaks or persistent pulmonary hypertension (PPHN). There has been a tremendous change in the concepts of pathophysiology and management of MAS over the last few decades. Routine endotracheal suctioning is no longer recommended in both vigorous and nonvigorous neonates with MSAF. Supportive management, along with newer therapies such as surfactant, inhaled nitric oxide, and high-frequency ventilation, has resulted in marked improvement in the overall outcome of MAS. The present review highlights the challenges in understanding the complex pathophysiology and optimal management approach to MAS. Potential future therapies and drugs in trial are also discussed briefly.

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Section: Future Therapymentioning

confidence: 99%

Meconium aspiration syndrome: challenges and solutions

Goel¹,

Nangia²

2017

RRN

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“…The mortality rate in newborn infants has been reported between 10 and 40% (4,5). In our study, 14.3% of newborn infants, diagnosed with meconium aspiration syndrome, died.…”

Section: Discussionmentioning

confidence: 45%

“…Meconium aspiration syndrome (MAS) occurs in 1.3% of live births and symptoms range from mild respiratory distress syndrome with auto recovery to progressive respiratory failure, complications and death, and in the most severe cases, respiratory distress, hypoxia, hypercapnia and respiratory acidosis increase, requiring intensive care and mechanical ventilation (1)(2)(3), and 10 to 40% of cases result in infant's death (4,5).…”

Section: Introductionmentioning

confidence: 99%

An Investigation of the Mortality Rate and Risk Factors in Newborn Infants With Meconium Aspiration Syndrome

et al. 2016

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Background: One of the serious challenges facing neonatal medicine is meconium aspiration syndrome, delays in the treatment of which can lead to high mortality. Objectives: This study was designed and conducted with the aim of determining the mortality rate and risk factors affecting this rate in newborn infants with meconium aspiration syndrome. Methods: This study was conducted as a retrospective descriptive research on newborn infants with meconium aspiration syndrome hospitalized at the neonatal intensive care unit (NICU) of Fatemieh and Be'sat hospitals in Hamadan city during a 10-year period from 2004 to 2014. Demographic information of the mother and the newborn, hospitalization course, the need for mechanical ventilation, and complications and outcomes of disease were extracted and were analyzed using the SPSS software version 22. Results: Sixty-three newborn infants, diagnosed with meconium aspiration syndrome, were entered in this study, 40% of them were male, 85.7% wighed more than 2500 g, and 17.5% were post term, 25.3% had a five-minute Apgar Score (AS5min) of less than seven, 39.6% were nonvigorous at birth, 31.8% needed to be placed on mechanical ventilation, and 14.3% died during the hospitalization course. There was a significant relationship between the need for mechanical ventilation, nonvigorous state at the birth, complications of disease and mortality rate. Conclusions: Despite the progress made in medicine, meconium aspiration syndrome is still one of the causes of newborn infants' mortality. The mortality and morbidity rates can be reduced by improvement in perinatal care, prevention of post term delivery, timely caesarean and effective neonatal resuscitation at birth.

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“…Aspiration of meconium interferes with normal respiratory physiology by causing airway obstruction, chemical irritation, inflammation, surfactant inactivation, meconium induced apoptosis and there is increased risk to develop air leaks, Persistent Pulmonary Hypertension of newborn (PPHN) and sepsis. 8,9 Respiratory distress with marked tachypnea, retractions, grunting, nasal flaring, and cyanosis ensues soon after birth. Affected infants typically have a barrel-shaped chest with an increased anterior-posterior diameter caused by overinflation.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2020

MIJOPED

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Background: MAS is defined as respiratory distress in a neonate born through meconium-stained amniotic fluid (MSAF) with characteristic radiological findings (hyperinflation and patchy opacities) whose symptoms cannot be explained otherwise. Use of surfactant is also recommended for treatment of MAS. Surfactant is administered intratracheally as either a bolus dose or in dilute form to lavage the lungs in neonates with MAS. In this study, we evaluated role of surfactant therapy in patients of meconium aspirations at our tertiary health care center. Material and Methods: This was a prospective, observational study carried out in neonates with evidence of meconium aspiration syndrome such as presence of meconium stained amniotic fluid or staining of meconium in skin, umbilical cord or nails, presence of meconium below vocal cords and Chest x-ray suggestive of meconium aspiration. Results: In present study 30 cases were included satisfying inclusion and exclusion criteria. In study 18 male and 12 female babies were included. 19 babies were term while 11 babies were pre-term. 21 babies were Appropriate for Gestational Age and 9 babies were small for Gestational Age. Mean gestational age was 37.2 ±1.6 weeks. Mean birthweight was 2190 ± 280 grams. 22 babies were vaginally delivered, 8 delivered by LSCS. Intrapartum 17 babies had fetal heart rate abnormalities. 4 babies needed Chest compressions , 2 needed epinephrine during resuscitation. 2 babies received intubated and on PPV in NICU and 3 babies needed positive pressure ventilation (PPV) at birth,. APGAR scores at 1 min, 5 min and 10 minutes are noted. Average maximum respiratory distress score was 6 ±1.6. 21 babies needed mechanical ventilation. Average duration of mechanical ventilation was 18.5 ± 43.8 hours while average duration of CPAP was 26.4 ± 19.3 hours. 11 ± 8.5 days was average duration of hospital stay. We noted Sepsis, Pneumothorax. PPHN in 4,1 and 1 cases respectively. 22 babies were discharged uneventfully. We noted mortality in 8 cases. Conclusion: Meconium aspiration syndrome is a serious and potentially preventable condition . Surfactant therapy in MAS can reduce the severity of respiratory illness and progressive respiratory failure when used early and judiciously in infants with severe respiratory distress.

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Predictors of mortality in neonates with meconium aspiration syndrome

Abstract: Meconium aspiration syndrome is associated with significant mortality. Myocardial dysfunction, birth weight, and initial oxygen requirement are independent predictors of mortality.

Cited by 39 publications

References 13 publications

Meconium aspiration syndrome: challenges and solutions

Meconium aspiration syndrome: challenges and solutions

An Investigation of the Mortality Rate and Risk Factors in Newborn Infants With Meconium Aspiration Syndrome

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