Clinical Analysis Of 612 Meconium Aspiration Syndrome And Their Risk Factors Of Compilications

Objective:To investigate the different clinical characteristics of infants with Meconium aspiration syndrome (MAS) nearly twenty-one years, to summarize medical experiences, to analyze the outcomes、the complications and theirs risk factors.Methods:We collected a total of 612 cases of MAS in our neonatal department from May.1993 to May.2014. They were grouped by hospitalized year、clinical outcomes、level of amniotic fluid、mechanical ventilation, described their clinical characteristics, analyzed their clinical outcomes、the complications and theirs risk factors.Results:1. The proportions of children with MAS over the same period were 0.89%(713/80051), removed 101 cases without detailed clinical datas. The cases and proportion of children with MAS increased from 2008 significantly.2. The term and post-term infants were 553 (90.36%),average gestational age was 39.53±2.20 week.433 cases had good prognosis (discharged and improved),179 cases had bad prognosis (dead and treatment abandoning). Average hospital days were 9.72±6.84 days.354 were cesarean delivery.3. Elderly parturient women were 97cases. The mainly diseases of mothers were Pregnancy Induced Hypertension (PIN)、gestational diabetes mellitus(GDM)、cholestasis、 Anemia. Ⅲ° of amniotic fluid was 530.354 was cesarean delivery.117 were Premature rupture of membrane (PROM). oligohydramnio was 155. Fetal distress was 269. Umbilical cord abnormality was 185. Placenta abnormality was 64.1 minutes apgar score<8 was 334 and 5 minutes apgar score<7 was 182.468 cases had asphyxia. Skin with meconium and rales were the mainly clinical feature. The degree of X-ray was not associated with the level of meconium stained amniotic fluid. The mainly complications were respiratory failure(345), pulmonary hypertension(101), hypoxic-ischemic encephalopathy(329), air leak(103), pulmonary hemorrhage(63), intracranial hemorrhage(130).4. Gestational age>40W, cesarean delivery and the severe X-ray were the risk factors of air leak, suction meconium at birth from airway was its protective factor. Asphyxia, Elderly parturient women, Gestational age>40W and Ⅲ° of amniotic fluid were the risk factors of HIE.Conclusion:MAS was the common disease in neonatal, which has lots of and severe complications. In this study, MAS was more common in term and post-term infants. Most of them had anoxia in perinatal period; The mainly complications were pulmonary hypertension n hypoxic-ischemic encephalopathy, air leak, pulmonary hemorrhage and intracranial hemorrhage. Gestational age>40W, cesarean delivery and the severe X-ray were the risk factors of air leak, suction meconium at birth from airway was its protective factor. Asphyxia, Elderly parturient women, Gestational age>40W and III°of amniotic fluid were the risk factors of hypoxic-ischemic encephalopathy. From this study, we know that perinatal care was beneficial.