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Meconium aspiration syndrome: have we made a difference?
T E Wiswell1, J M Tuggle, B S Turner
1Department of Pediatrics, Walter Reed Army Medical Center, Washington, DC 20307-5001.
Pediatrics
|May 1, 1990
Summary
Meconium aspiration syndrome (MAS) incidence and mortality significantly decreased from 1973-1987, likely due to improved perinatal care and suctioning. However, severe MAS and related deaths cannot be entirely prevented.
Area of Science:
- Neonatal Medicine
- Perinatal Care
- Pediatric Pulmonology
Background:
- Meconium aspiration syndrome (MAS) is a significant cause of neonatal respiratory distress.
- Historically, MAS management evolved with interventions like intubation and suctioning.
- The period 1973-1987 saw changes in obstetric and pediatric care practices.
Purpose of the Study:
- To review the incidence, complications, and mortality of MAS.
- To analyze trends in MAS over a 15-year period (1973-1987).
- To evaluate the impact of interventions on MAS outcomes.
Main Methods:
- Retrospective review of 176,790 neonates born between 1973 and 1987.
- Analysis of meconium-stained amniotic fluid and subsequent MAS development.
- Statistical comparison of MAS incidence, complications, and mortality over time.
Main Results:
- MAS developed in 5.41% of meconium-stained neonates; incidence significantly decreased over the study period (P = .043).
- The MAS death rate significantly declined (P = .041), with 4.22% mortality.
- Mechanical ventilation (29.7%) and pneumothorax (11.53%) rates did not decrease.
Conclusions:
- The decline in MAS incidence and mortality is linked to improved perinatal care and suctioning techniques.
- Despite advancements, severe MAS and associated fatalities remain a concern.
- Current interventions have reduced, but not eliminated, the risk of severe MAS.