scholarly journals Meconium Aspiration Syndrome: A Narrative Review

Children ◽  
2021 ◽  
Vol 8 (3) ◽  
pp. 230
Author(s):  
Chiara Monfredini ◽  
Francesco Cavallin ◽  
Paolo Ernesto Villani ◽  
Giuseppe Paterlini ◽  
Benedetta Allais ◽  
...  
Keyword(s):  
Developing Countries ◽  
Respiratory Failure ◽  
Survival Rate ◽  
Perinatal Care ◽  
Developed Countries ◽  
Meconium Aspiration Syndrome ◽  
Meconium Aspiration ◽  
The 1960S ◽  
Meconium Stained Amniotic Fluid

Meconium aspiration syndrome is a clinical condition characterized by respiratory failure occurring in neonates born through meconium-stained amniotic fluid. Worldwide, the incidence has declined in developed countries thanks to improved obstetric practices and perinatal care while challenges persist in developing countries. Despite the improved survival rate over the last decades, long-term morbidity among survivors remains a major concern. Since the 1960s, relevant changes have occurred in the perinatal and postnatal management of such patients but the most appropriate approach is still a matter of debate. This review offers an updated overview of the epidemiology, etiopathogenesis, diagnosis, management and prognosis of infants with meconium aspiration syndrome.

scholarly journals Neonatal Respiratory Distress Secondary to Meconium Aspiration Syndrome

Children ◽  
2021 ◽  
Vol 8 (3) ◽  
pp. 246
Author(s):  
Arielle L. Olicker ◽  
Thomas M. Raffay ◽  
Rita M. Ryan
Keyword(s):  
Respiratory Distress ◽  
Amniotic Fluid ◽  
Supplemental Oxygen ◽  
Meconium Aspiration Syndrome ◽  
Meconium Aspiration ◽  
Life Saving ◽  
Long Term Prognosis ◽  
Neurological Insult ◽  
Meconium Stained Amniotic Fluid

Infants born through meconium-stained amniotic fluid (MSAF) are 100 times more likely than infants born through clear amniotic fluid to develop respiratory distress in the neonatal period. Meconium aspiration syndrome (MAS) is a common cause of respiratory distress in term and post-mature neonates. MAS is defined as respiratory distress accompanied by a supplemental oxygen requirement in an infant born with MSAF, in the absence of any other identified etiology to explain the symptoms. Therapy for MAS is supportive, and should be tailored to each infant’s specific pathophysiology. In cases of MAS with severe persistent pulmonary hypertension of the newborn (PPHN), patients may remain hypoxic despite aggressive ventilation, and in these cases surfactant, inhaled nitric oxide (iNO) and extracorporeal membrane oxygenation (ECMO) can be life-saving. Long-term prognosis for MAS is more related to severity of initial hypoxemia and possible neurological insult than to the pulmonary pathology.

Low birthweight and poor foetal growth

2018 ◽  
pp. 164-167
Author(s):  
Gabriela Cormick ◽  
Nicole Minckas ◽  
José Belizán
Keyword(s):  
Developing Countries ◽  
Low Birthweight ◽  
Perinatal Care ◽  
Preterm Births ◽  
Developed Countries ◽  
Health Concern ◽  
Spontaneous Preterm Birth ◽  
Associated Conditions ◽  
Long Term Consequences

Low birthweight (LBW) infants constitute a major public health concern in developed and developing countries. LBW infants includes those that were born early (preterm births), those that were born with intrauterine growth restricted (IUGR), or a combination of both. IUGR as a result of chronic malnutrition is more prevalent in developing countries and usually shows more long-term consequences. IUGR infants as a result of acute foetal malnutrition predominate in developed countries and usually have more complications immediately after birth but lower long-term consequences. The WHO 2025 global target is to achieve a 30% reduction in LBW infants. Research should focus on: testing evidence-based interventions starting before pregnancy to improve women’s nutrition in order to stop the vicious circle of malnutrition; treating pregnancy associated conditions such as pre-eclampsia; providing adequate perinatal care and social support; and Identifying risk factors of spontaneous preterm birth, as most causes are unknown.

Surfactant Therapy in Full-term Neonates With Severe Respiratory Failure

PEDIATRICS ◽  
1993 ◽  
Vol 92 (1) ◽  
pp. 135-139
Author(s):  
Hatem Khammash ◽  
Max Perlman ◽  
Julian Wojtulewicz ◽  
Michael Dunn
Keyword(s):  
Respiratory Failure ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Oxygenation Index ◽  
Meconium Aspiration Syndrome ◽  
Full Term ◽  
Surfactant Therapy ◽  
Term Infants ◽  
Meconium Aspiration

Objective. In light of the paucity of published data on the use of surfactant in full-term infants with respiratory failure due to meconium aspiration syndrome and respiratory distress syndrome, we report our experience with this therapy. Our goal was to explore possible justification for randomized controlled trials of surfactant treatment in similar patients at an earlier, less severe stage of the disease. Methods. Retrospective consecutive case series of 20 infants with severe meconium aspiration syndrome and 29 infants with severe respiratory distress syndrome who received bovine surfactant between March 1990 and December 1992 in three neonatal intensive care units in a regionalized setting. Outcome of treatment was assessed by comparing changes in several respiratory indices including the oxygenation index, between 4 and 6 hours and 1 and 3 hours before and after the first dose of surfactant. Differences were analyzed using analysis of variance for repeated measures, with treatment and time as co-variates. Results. In the meconium aspiration group the mean oxygenation index decreased from 36 ± 12 at 1 to 3 hours presurfactant to 24 ± 14 at 1 to 3 hours postsurfactant (P < .001). In the patients with respiratory distress syndrome the mean oxygenation index fell from 30 ± 17 at 1 to 3 hours presurfactant to 12 ± 6 at 1 to 3 hours postsurfactant (P = .0001). Three of 20 patients with meconium aspiration syndrome and 3 of 29 patients with respiratory distress syndrome received extracorporeal membrane oxygenation. Conclusions. Surfactant therapy in full-term infants with respiratory failure due to the meconium aspiration and respiratory distress syndromes is often effective in improving gas exchange. A randomized controlled trial of surfactant therapy at an earlier stage in the course of the illness should be performed.

scholarly journals Study of early neonatal outcomes in babies delivered through meconium-stained amniotic fluid in a rural teaching hospital

2021 ◽  
Vol 8 (4) ◽  
pp. 642
Author(s):  
Venkatesh Dhannaram ◽  
Sumathi Kotapuri ◽  
Sudharshanraj Chitgupikar
Keyword(s):  
Respiratory Distress ◽  
Amniotic Fluid ◽  
Admission Rate ◽  
Meconium Aspiration Syndrome ◽  
Multiple Gestation ◽  
Meconium Aspiration ◽  
Emergency Cesarean ◽  
Nicu Admission ◽  
A Prospective Study ◽  
Meconium Stained Amniotic Fluid

Background: When the fetus is in a state of stress meconium is passed presence of meconium in amniotic fluid is potentially a serious Sign of fatal compromise, frequency of meconium strained amniotic fluid ranges from 5-22%. MSAF results in higher rate of cesarean delivery, NICU admission rate, respiratory distress, PPHN and neonatal death. The primary objectives of the study were to estimate the incidence of Meconium aspiration syndrome & Respiratory distress among babies born through meconium-stained amniotic fluid (MSAF) along with studying the outcomes at the end of 7 days.Methods: This was a prospective study undertaken in mediciti institute of medical sciences, Ghanpur Medchal Mandal from Jan 2018 to June 2019. Data was collected in a predetermined proforma after institutional ethical committee clearance and appropriate informed consent.Results: During this period 1972 neonates were delivered of which 216 babies were born through MSAF. 18 were excluded for non-cephalic presentation, multiple gestation or congenital anomalies.198 babies were included in the study (96 male and 102 female). 18 neonates (10.2%) needed resuscitation at birth. 85 (42.9%) had thick MSAF. 43 of them developed respiratory distress (21.7%). 10 babies were ventilated. Seizures, hyperbilirubinemia, thrombocytopenia were more common among babies with thick MSAF. Mortality was 1%.Conclusions: Thick meconium-stained amniotic fluid was associated with low Apgar score, higher rate of emergency cesarean section and meconium aspiration syndrome. Primigravida mothers, maternal hypothyroidism and oligohydramnios were important risk factors associated with MAS.

Early Intubation and MAS

PEDIATRICS ◽  
1991 ◽  
Vol 87 (2) ◽  
pp. 269-269
Author(s):  
LIONEL D. TRAVERSE
Keyword(s):  
Vagal Stimulation ◽  
Meconium Aspiration Syndrome ◽  
Meconium Aspiration ◽  
Early Intubation ◽  
Transient Bradycardia

To the Editor.— I was particularly interested by the article by Wiswell et al, entitled "Meconium Aspiration Syndrome: Have We Made a Difference?"1 because it is one of the few articles that has addressed issues of direct interest for the "trenches paediatrician." I would like to propose the following comments to the authors. Intubation of a newborn, by an experienced and trained person, is a benign gesture. Except for the occasional vagal stimulation and very transient bradycardia associated, and the potential trauma to cords (which in good hands is probably easy to avoid), I am not aware of any medium- or long-term sequelae of intubating an infant once or twice.

scholarly journals A study of maternal risk factors and the perinatal outcome in meconium stained amniotic fluid in central referral hospital

2019 ◽  
Vol 8 (11) ◽  
pp. 4146
Author(s):  
Kapil Singh Niranjan ◽  
Pesona Grace Lucksom
Keyword(s):  
Risk Factors ◽  
Amniotic Fluid ◽  
Perinatal Outcome ◽  
Significant Risk ◽  
Birth Asphyxia ◽  
Meconium Aspiration Syndrome ◽  
Meconium Aspiration ◽  
Maternal Risk ◽  
Prolonged Labor ◽  
Meconium Stained Amniotic Fluid

Background: Meconium staining of amniotic fluid (MSAF) is a significant risk factor for the subsequent development of meconium aspiration syndrome (MAS), respiratory distress and eventual respiratory failure in neonates. To learn more about the risk factors and outcomes associated with MSAF, a prospective case control study was conducted. The objective of the study was to study various maternal risk factors associated with MSAF and to study the outcome of neonates born through MASF and to compare the perinatal outcome in patients with thick and thin meconium stained amniotic fluid.Methods: A hospital based prospective case control study was conducted comparing pregnant women with meconium stained (cases) amniotic fluid with pregnant women having clear liquor (control), 200 in each arm. Singleton pregnancies complicated with MASF were included in the cases group on the basis of predefined inclusion criteria. Various risk factors, mode of delivery, outcome of neonates and perinatal outcome in babies born through thick and thin meconium stained amniotic fluid was studied.Results: Out of 200 patients who had MSAF 114 patients (57%) had thick meconium stained liquor while remaining 86 patients (43.00%) had thin meconium stained amniotic fluid. Post-maturity, pregnancy induced hypertension; oligohydramnios and prolonged labor were found to be statistically significant risk factors for MSAF. Nonreactive non-stress test and Need for cesarean section was more common in women with MSAF as compared to women with clear liquor (p <0.05). Common morbidities in neonates were Birth asphyxia (15%) followed by meconium aspiration syndrome (10%) and hypoxic ischemic encephalopathy (15%).Conclusions: Meconium stained amniotic fluid is more commonly associated with post-maturity, pregnancy induced hypertension, oligohydramnios and prolonged labor low APGAR score and higher incidence of birth asphyxia and NICU admissions. Appropriate management of neonates with meconium aspiration syndrome is crucial to prevent neonatal mortality.

Assessing the Factors Affecting the Implementation of E-Government and Effect on Performance of DVLA

2019 ◽  
Vol 15 (1) ◽  
pp. 47-61
Author(s):  
Gerald Dapaah Gyamfi ◽  
George Gyan ◽  
Mavis Ayebea ◽  
Florence Naa Norley Nortey ◽  
Prince Yaw Baidoo
Keyword(s):  
Developing Countries ◽  
Financial Constraints ◽  
Sampling Technique ◽  
Developed Countries ◽  
Electronic Government ◽  
Electricity Supply ◽  
Successful Implementation ◽  
Factors Affecting ◽  
Ict Infrastructure

Though many researchers have carried out studies on electronic government (e-government) and its effect on performance of public organizations in developed countries not much such studies have taken place in developing countries, creating a gap in literature. The current study seeks to fill the gap. The study highlights the factors affecting the implementation and sustainability of E-government and effect of the factors on performance of the driver and vehicle licensing agency (DVLA) in Ghana. The study used purposive sampling technique to gather data from the DVLA (N-50) in 2016. The outcome of the study revealed that the challenges that impede the successful implementation of e-government include regular interruption of the electricity supply, online theft, poor ICT infrastructure, and financial constraints. Based on the benefits associated with the implementation of e-government, the current researchers made recommendations for long-term sustainability of e-government.

Forward planning: meeting the requirements. The world food and agricultural situation

1973 ◽  
Vol 267 (882) ◽  
pp. 5-12 ◽  
Keyword(s):  
Developing Countries ◽  
Developed Countries ◽  
Technological Problem ◽  
Trade Policies ◽  
World Food ◽  
Planning Meeting ◽  
The World ◽  
The 1960S ◽  
The Developed Countries ◽  
Obvious Feature

The world food and agricultural situation in the 1980s must be looked at, as now, in terms of the division between developed and developing countries. While there will still be problems in the developed countries - such as surpluses - the great crisis will remain in the developing countries. The most obvious feature of the crisis is the balance between the increase in population and the increase in food production. In the 1960s, the balance was extremely precarious and, in the first two years of the 1970s, population actually grew faster than production. Hence, it is imperative to accelerate the increase in production in the developing countries. In order to achieve this, it is important to see to what extent the obstacles are due to lack of knowledge on how to obtain more from natural resources - primarily a technological problem - and to what extent they are due to the weaknesses of human institutions and of the political will for change. In addition, the prospects for a more rational and hopeful world food and agricultural situation in the 1980s will depend very largely on how the national agricultural production and trade policies of both developed and developing countries can be modified by practical steps towards international agricultural adjustment for the benefit of all.

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