Risk factors differentiating mild/moderate from severe meconium aspiration syndrome in meconium-stained neonates

Choi, Woneui; Jeong, Heejeong; Choi, Suk‐Joo; Oh, Soo‐Young; Kim, Jung-Sun; Roh, Cheong‐Rae; Kim, Jong-Hwa

doi:10.5468/ogs.2015.58.1.24

Cited by 34 publications

(47 citation statements)

References 41 publications

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“…Similar results have been demonstrated by Benny PS et al, 19 where meconium aspiration was associated with prolonged labour. Interesting results can also be found in Woneui C. et al, 20 where severe MAS was associated with a shorter duration of the second stage of labour, and mild to moderate meconium aspiration syndrome -with prolonged labour. This suggests that birth through meconium stained amniotic fluid should not be prolonged and, if other warning signs are manifest during labour, should be terminated in the safest and quickest way possible.…”

Section: −15mentioning

confidence: 54%

Risk factors that can lead to development of meconium aspiration syndrome

Rovas¹,

Razbadauskas²,

Boguziene³

2018

OGIJ

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Objective: To determine the frequency of Meconium Aspiration Syndrome (MAS) in neonates born through Meconium Stained Amniotic Fluid (MSAF) and to identify the risk factors that can lead to the development of MAS. Method:The study includes all neonates born in 2014 through MSAF. Risk factors associated with pregnancy, delivery and the neonates' condition were identified. Results between groups -the Meconium Aspiration Syndrome (MAS) group, the meconium in the lower vocal cords, but no Meconium Aspiration Syndrome (MLVC) group, and the MSAF group -were compared.Results: Out of the 2040 births in 2014, 307 neonates were born through meconium stained amniotic fluid. MAS were confirmed in 17 neonates (5.5%). Statistically significant differences between the MAS and the MSAF groups were found in the following: parity (MAS was more likely in nulliparous women (p-0.024, RR-1.8, 95% CI 1.4-2.3; p-0.045), the BMI of women (28.2±4.1 in the MSAF group and 30.6±4.2 in the MAS group (T-2.24; p-0.027)), and respiratory tract infections and anaemia during pregnancy, which were more common in the MAS group (p-0.02 ; p-0.035). MAS was more likely to occur upon induction of labour, meconium was thick, and the duration of labour was longer in first and second stages (p-0.003, p-0.0022, p-0.022, p-0.000). 60% of neonates who developed MAS were born through cesarean-section, compared to 31% born through cesarean-section in the MSAF group (p-0.043). Pathological changes in CTG were more common in the MAS group (47% compared to 4% in the MSAF group, p-0.035). The likelihood of MAS in neonates was found to increase with lower Apgar scores at minute 1 and minute 5; lower cord blood pH was also a risk factor for MAS (p-0.000, p-0.000, p-0.009). Conclusions:Prolonged labour, lower Apgar scores, induction of labour, thick meconium, nulliparity, respiratory tract infections and anaemia during pregnancy were associated with MAS. Factors such as urinary tract infections, hypertensive disorders, neonate birth weight and sex were not found to be statistically significant in this study.

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Section: −15mentioning

confidence: 54%

Risk factors that can lead to development of meconium aspiration syndrome

Rovas¹,

Razbadauskas²,

Boguziene³

2018

OGIJ

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“…Konvansiyonel ve yüksek frekanslı ventilasyon tedavilerine yanıt vermeyen OI > 40 olan hastalarda ekstrakorporeal membran oksijenasyonu (ECMO) imkanlar ölçüsünde düşünülmelidir. Inflamasyonu baskılayıcı yeni ilaç tedaviler üzerindeki araştırmalar ise halen devam etmektedir (8,15). Tanı konulduktan sonra yeterli oksijenizasyonu sağlamak ve hiperoksi kaynaklı akciğer hasarını azaltmak için arteryel kanda PaO 2 (55-90) olacak şekilde satürasyonu SaO 2 > %90 tutulmalıdır.…”

Section: Solunum Desteği Yönetimiunclassified

“…Mortaliteyi etkileyen hava kaçağı sendromları ve pulmoner interstisyel amfizem %10-30 oranında gözlen-mektedir. Böbrek yetmezliği, intestinal iskemiye bağlı nekrotizan enterokolit, hipoksiye bağlı karaciğer fonksiyon testlerinde ve koagulasyon sisteminde bozulma, sürrenal kanama, sepsis bu hastalarda morbidite ve mortaliteyi etkileyen başlıca diğer ek sorunlardır (8,16). Yaşayanlar-da nörogelişimsel gerilik mekonyum aspirasyonundan ziyade intrauterin dönemde amniyon sıvısına geçen ve aspire edilen mekonyumun yarattığı kronik hipoksi ve asidoza bağlanmak-tadır.…”

Section: Solunum Desteği Yönetimiunclassified

“…Hava yollarınının mekanik blokajı, sürfak-tanın inaktivasyonu ve pulmoner hipertansiyon MAS'a bağlı solunum sıkıntısı sendromunun temel bileşenlerini oluşturmaktadır (Şekil 1) (8,9). Deneysel olarak MAS'ta en çok çalışı-lan mediatörler sitokinler, kompleman sistem, reaktif oksijen radikalleri (ROS), nitrik oksit (NO), araşidonik asit metabolitleri ve transkripsiyon faktörleridir.…”

Section: Introductionunclassified

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Mekonyum Aspirasyon Sendromu ve Yaklaşımındaki Yenilikler

Toptan

Karadağ²,

Karatekın³

2016

Zeynep Kamil Tıp Bülteni

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“…Women that had undergone cesarean section (CS) were excluded as meconium -staining rates are generally low during CS and high at the second stage of labor ≥ 24 cm was considered polyhydramnios. [3][4][5][6] The degree of echogenicity of AF on USG before labor and degree of meconium during labor were determined as follows. Placenta-like appearance was defined as thick, and that between was defined as mild echogenicity.…”

Section: Methodsmentioning

confidence: 99%

The Degree of Ultrasonographic Amniotic Fluid Echogenicity for the Prediction Meconium Staining During Labor

Şentürk¹,

Çakmak²,

Budak³

2016

Turkiye Klinikleri J Gynecol Obst

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A AB BS S T TR RA AC CT T O Ob bj je ec ct ti iv ve e: : The aim of this study is to evaluate the relationship between appearance of amniotic fluid on ultrasound and presence of meconium during labor. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : This prospective study was conducted on 376 laboring women. The relationship between the degree of amniotic fluid echogenicity (normal, mild, intense) and degree of meconium stained amniotic fluid (clear, mild, thick) during labor was investigated. Positive and negative predictive values for determining meconium-staining amniotic fluid were evaluated using chi-square and Fisher's-exact tests. A value of p<0.05 was accepted as statistically significant. R Re es su ul lt ts s: : The rate of echogenic amniotic fluid imaging on ultrasound was 44.4%. The consistency rate between the ultrasonography and amniotic fluid examination during/after labor was 51.1%, which was not statistically significant (p=0.121). However the negative predictive value of non-thick echogenicity was 84.3% in ruling out thick meconiumstained fluid, only when amniotic fluid index was normal (p<0.05). C Co on nc cl lu us si io on n: : Ultrasonographic echogenity of amniotic fluid is generally not a reliable method for predicting meconium-stained amniotic fluid. However in pregnancies with normal amniotic fluid, absence of thick echogenicity seems reliable for predicting the absence of thick meconium-stained amniotic fluid.K Ke ey y W Wo or rd ds s: : Meconium; ultrasonography; amniotic fluid; labor, obstetric Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışmanın amacı, ultrasonografik muayenede saptanan ekojenik amniotik sıvı görünümü ile doğum sırasında amniotik sıvıdaki mekonyum varlığı arasındaki ilişkiyi araştırmak-tır. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Prospektif bu çalışma doğum yapan 376 kadın üzerinde yapıldı. Amniotik sıvının ekojenite derecesi ile (normal, orta derecede, yoğun) doğum sırasında mekonyum boyalı amniyotik sıvı derecesi (temiz, orta derecede mekonyumlu, koyu mekonyumlu) arasındaki ilişki araştırıldı. Mekonyum boyalı amniyotik sıvı varlığını belirlemede pozitif ve negatif belirleyici değer ki-kare ve Fisher's-exact testleri kullanılarak saptandı. P değerinin 0,05 altında olması anlamlı olarak kabul edildi. B Bu ul lg gu ul la ar r: : Ultrasonda saptanan ekojenik amniyotik sıvı görüntüsü oranı %44,4. idi. Ultrason bulguları ile doğum esnasında ya da sonrasındaki amniyon mayii muayenesi arasındaki uyum %51,1 olup anlamlı değildi (p=0,121). Bununla beraber ultrason muayenesindeki yoğun olmayan ekojenitenin doğum sırasında ya da sonrasında yoğun mekonyum boyalı amniyon mayisini dışla-madaki belirleyici değeri %84,3 olup anlamlı idi (p<0.05). Fakat bu sadece amniyon mayii indeksi normal olan olgularda geçerli idi. S So on nu uç ç: : Amniyon mayisinin ultrasondaki ekojenik görüntüsü mekonyum boyalı amniyon mayii belirlemede genel olarak güvenilir bir yöntem değildir. Bununla beraber amniyon mayii indeksi normal olan gebelerde koyu ekojenitenin varlığı koyu mekonyu...

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Risk factors differentiating mild/moderate from severe meconium aspiration syndrome in meconium-stained neonates

Cited by 34 publications

References 41 publications

Risk factors that can lead to development of meconium aspiration syndrome

Risk factors that can lead to development of meconium aspiration syndrome

Mekonyum Aspirasyon Sendromu ve Yaklaşımındaki Yenilikler

The Degree of Ultrasonographic Amniotic Fluid Echogenicity for the Prediction Meconium Staining During Labor

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