Authors: Nalan Karabayir Ali Demirel Elvan Bayramoglu
Publish Date: 2014/09/26
Volume: 291, Issue: 4, Pages: 849-853
Abstract
Approximately 5 of infants born with a meconiumstained amniotic fluid MSAF develop meconium aspiration syndrome MAS Early recognition of infants at highest risk for the development of MAS and the prediction of disease severity are important for optimizing the clinical strategies for prevention and treatment The aim of the present study was to identify the risk factors for MAS and to investigate the effect of blood lactate level on the development of MASBetween January 2011 and January 2012 data were recorded with regard to gender mode of delivery gestational week birth weight 5min Apgar score and need for resuscitation of the meconiumstained depressed infants who underwent tracheal aspiration Moreover the number of cases developing MAS blood pH value and lactate level in capillary blood gases obtained during the first hour after delivery duration of oxygen supplementation the number of cases receiving mechanical ventilation and surfactant therapy duration of hospital stay and outcomes of the infants were recordedThe number of live births during the study period was 17202 and of them 1341 78 infants were born through MSAF Of 195 infants who were meconiumstained depressed 90 were girls and 105 were boys Their mean gestational week was 3937 ± 089 weeks and mean birth weight was 3426 ± 634 g Eightyfour of them were born through cesarean section C/S and 111 were born via normal spontaneous labor For 40 infants Apgar score at fifth minute was less than 6 In total resuscitation was performed on 43 229 infants Of the infants 141 did not develop MAS and 54 developed MAS While there were no significant differences between infants with and without MAS with regard to gender delivery route gestational week and birth weight a significant difference was observed regarding the Apgar score p = 00001 The blood pH value in capillary blood gas analysis was less than 725 in 18 285 cases with MAS and four 32 cases without MAS There was no significant difference between infants with and without MAS with regard to blood pH levels p = 0031 The mean blood lactate level was 85 ± 34 mmol/L in the patients with MAS and there was a significant difference between infants with and without MAS regarding blood lactate level p = 00001 The mean duration of oxygen supplementation was 8662 ± 6652 and 4436 ± 1903 h in patients with MAS and without MAS respectively In total 30 infants required mechanical ventilation 24 infants with MAS and 6 infants without MAS In addition to mechanical ventilation 16 infants with MAS were administered surfactant therapy The mean duration of hospital stay of infants with MAS was significantly higher than infants without MAS p = 00001 There was a correlation between blood lactate levels blood pH value and hospitalization duration p 005 All of the infants except one patient were discharged from the NICUIn addition to the blood pH value and 5min Apgar score increased blood lactate level may be a risk factor for the development of MAS in infants born with MSAF This may aid in the early detection of MAS and with appropriate measures taken sooner reduce morbidity and mortality Further studies are needed to elucidate the role of lactate level which is an important indicator of hypoxia during the development of MAS
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