Risk Factors of Neonatal Death in Meconium Aspiration Syndrome at Trang Hospital
Keywords:Meconium Aspiration Syndrome, Meconium stained amniotic fluid, non vigorous neonate
Background: Meconium aspiration syndrome ( MAS ) is an important cause of acute respiratory distress in newborn , which has serious complication and high mortality rate. Objectives: To determine the incidence , outcome and complications of infants with MAS and prognostic factors of this conditions at Trang Hospital. Methods: This study was a retrospective descriptive study. Medical records of infants who diagnosed with MAS at Trang hospital between 1st October 2016 and 30nd September 2019 were reviewed. Data on maternal and neonatal demographics , clinical course and outcome were recorded. Results: Meconium stained amniotic fluid (MSAF) was found in 556 neonates. Two hundred three neonates of MAS cases were enrolled , (36.5% of MSAF) , one hundred and fifty-nine newborn was born at Trang Hospital The incidence of MAS was 14.76 per 1000 live birth. Fifteen cases of MAS died ( mortality 7.4%) and 38.9% of MAS needed mechanical ventilation. The most common cause of death was persistent pulmonary hypertension of newborn (PPHN, 100 % ). Other cause was sepsis ( 87.6%). The significant poor prognostic factor of MAS were non vigorous neonate , APGAR score at 1 min and at 5 min < 3 , on mechanical ventilation , MAS with complication : PPHN , sepsis , birth asphyxia , pneumothorax and pulmonary hemorrhage. Conclusions: Incidence of MAS during this period at Trang Hospital was 14.76 per 1000 live birth. The mortality rate was 7.4%. Poor prognostic factor was non vigorous neonate, severe birth asphyxia , on mechanical ventilation , PPHN , sepsis , pneumothorax and pulmonary hemorrhage The most common cause of death was PPHN.
Fanaroff AA. Meconium aspiration syndrome: historical aspects. J perinatal 2008 ; 28 : supply 3: s3-7.
Wiswell TE,Bent RC. Meconium staining and the meconium aspiration syndrome. Pediatr Cli North Am 1993;40: 955-81.
Cleary GM, Wiswell TE. Meconium-stained amniotic fluid and the meconium aspiration syndrome: An update. Pediatr Clin North AM 1998; 45:511-29.
Klingner MC, Kruse J. Meconium aspiration syndrome: pathophysiology and prevention. J Am Board Fam Pract 1999; 12: 450-66.
Khorana M. Meconium aspiration syndrome.In :Punnahitanon S, Ngerncham S, Limrungsikul A ,eds. .Highlights in Neonatal Problems. Bangkok : Active print Co.Ltd, ; 2018. p 371-89.
Tsu F. Yeh. Core Concepts: Meconium aspiration syndrome: Pathogenesis and Current Management. Neoreview 2010 ;11;e503-11.
Engsirorat M. Outcome of Meconium aspiration syndrome in Udonthani Hospital. Thai J Pediatr 2018; 57: 43-50.
Chewaproug S. Risk Factor of neonatal Death in Meconium aspiration syndrome at PathumThani hospital. J Health sci 17.1 (2015): 46-56.
Siriyotiphan S. Risk Factor of Neonatal Death on Meconium Aspiration Syndrome in Prachuapkhirikhan Hospital. Reg 4 Med J 2000; 19(1):43-53.
Boonluksiri P, Nimdej K. Incidence and risk factors of meconium aspiration syndrome at Hatyai Hospital Songla Med J 2003; 21: 179-86.
International Liaison Committee on Resuscitation. 2005 International Consensus Conference on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations Part 7 : Neonatal resuscitation. Circulation 2005;112:III-91-9.
Kattwinkel J, Perlman JM, Aziz K , Colby C, Fairchild K, Gallagher J , et al Part 15: Neonatal Resuscitation 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 2010; 122:S909-19
Wyckoff MH, Aziz K, Escobedo MB, Kapadia VS , Kattwinkel J, Perlman JM, et al. Part 13 : Neonatal resuscitation:2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency cardiovascular Care. Pediatrics. 2015; 136: S196-218.
Jirapradittha J. Routine endotracheal suction is no longer recommended for non vigorous neonates born through meconium stained amniotic fluid, whether it is proper or not : An evidenced-based literature review. Thai J Pediatr 2016; 55: 226-38.
Zahid A, Tayyaba KB, Fariha A, Muhammad YK. Mortality in meconium aspiration syndrome in Hospitalized Babies. J Coll Phys Surg Pakistan 2011; 21:695-9.
L Panton, H Trotman. Outcome of neonatal with Meconium aspiration syndrome at the university Hospital of the West indies , Jamaica : A resource-limited setting .Am J perinatal 2017; 34: 1250-4.
Espinheira M, Grilo M, Rocha G, Guedes B, Guimaraes H. Meconium aspiration syndrome-the experience of tertiary center. Revista port de pneumo; 2011; 17:71-6.
Dargaville PA , Copnell B; for the Australian and New Zealand Neonatal Network. The Epidermiology of meconium aspiration syndrome : incidence , risk factor, therapies ,and outcome. Pediatr. 2006; 17:1712-21.
Trainak S, Siwadune T. Factor Association with Meconium aspiration syndrome in Cases with meconium-stained Amniotic fluid. TJOG 2016; 24:240-6.
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 intensive care during a ten-year period. J Perin. 2009; 29: 497-503.
How to Cite
Copyright (c) 2022 Department of Medical Services, Ministry of Public Health
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
ข้อความและข้อคิดเห็นต่างๆ เป็นของผู้เขียนบทความ ไม่ใช่ความเห็นของกองบรรณาธิการหรือของวารสารกรมการแพทย์