Document Detail


Meconium aspiration syndrome: intrapartum and neonatal attributes.
MedLine Citation:
PMID:  2589429     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To identify the fetus and newborn at risk for meconium aspiration syndrome the perinatal characteristics of 238 infants delivered through meconium-stained amniotic fluid were prospectively examined. All infants with meconium-stained amniotic fluid were routinely suctioned with a DeLee apparatus before tracheal intubation and suctioning. The type and presence of meconium in the trachea, neonatal breathing before intubation, and Apgar scores were recorded in the delivery room. Intrapartum fetal monitoring data were collected for 80% (190/238) of the mothers and umbilical artery pH for 74% (177/238) of the newborns. Despite suctioning with a DeLee apparatus and endotracheal suctioning, meconium was present in the trachea in 87/238 (37%) and meconium aspiration syndrome developed in 22 (9.2%). A total of 73% of newborns who had meconium aspiration syndrome were delivered through thick meconium. Thick meconium, the presence of fetal tachycardia, and absence of intrapartum fetal cardiac accelerations identified the fetus at high risk for meconium aspiration syndrome. The presence of these monitoring findings and thick meconium should alert obstetricians to the possibility of a fetus that requires intervention. Low umbilical artery pH, Apgar scores less than 5, and meconium in the trachea further characterized the newborn at high risk for meconium aspiration syndrome. The combination of these findings may best identify the infant delivered through meconium-stained amniotic fluid who requires close observation for meconium aspiration syndrome.
Authors:
E M Rossi; E H Philipson; T G Williams; S C Kalhan
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  161     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  1989 Nov 
Date Detail:
Created Date:  1990-01-04     Completed Date:  1990-01-04     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1106-10     Citation Subset:  AIM; IM    
Affiliation:
Perinatal Clinical Research Center, Case Western Reserve University School of Medicine, Cleveland Metropolitan General Hospital, OH.
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MeSH Terms
Descriptor/Qualifier:
Amniotic Fluid / metabolism
Apgar Score
Fetal Blood
Fetal Monitoring
Forecasting
Heart Rate
Humans
Hydrogen-Ion Concentration
Infant, Newborn
Intubation, Intratracheal
Meconium / metabolism
Meconium Aspiration Syndrome / etiology*
Prospective Studies
Risk Factors
Suction
Trachea / metabolism
Umbilical Arteries
Viscosity
Grant Support
ID/Acronym/Agency:
5MO1-RR00210/RR/NCRR NIH HHS
Comments/Corrections
Comment In:
Am J Obstet Gynecol. 1990 Jul;163(1 Pt 1):250-1   [PMID:  2375356 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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