Aldhafeeri Fahad Muqdhib, Aldhafiri Fawaz Mayouf, Bamehriz Maha, Al-Wassia Heidi
Dr. Fahad Muqdhib Aldhafeeri, Faculty of Medicine,, King Abdulaziz University,, Jeddah 21441,, Saudi Arabia, T: +966 595506503, dr.fahadaldh@ gmail.com, ORCID: https://orcid. org/0000-0002-9855-2166.
Ann Saudi Med. 2019 Mar-Apr;39(2):87-91. doi: 10.5144/0256-4947.2019.87.
In 2015, the Neonatal Resuscitation Program (NRP) guidelines were updated to recommend that nonvigorous infants delivered through meconium-stained amniotic fluid (MSAF) do not require routine intubation and tracheal suction.
Explore the implications of 2015 NRP guidelines on delivery room management and outcome of infants born through MSAF.
Retrospective cohort study.
King Abdul-Aziz University Hospital (KAUH).
All term ( greater than or equal 37 weeks) infants born in KAUH through MSAF between January 1, 2016, and December 31, 2017, were included. Patients were divided into two groups according to the date of birth: period 1 (January 1, 2016, to December 31, 2016), before the implementation of the new NRP guidelines; period 2 (January 1, 2017, to December 31, 2017), after the implementation.
Outcomes of infants born through MSAF.
420 infants.
A majority of infants (n=261) were born in period 1 and 159 after in period 2. No differences were found in the booking status of mothers, cesarean section rate, and number of deliveries attended by physicians between the 2 cohorts. Infants in both cohorts were of similar gestational age, birth weight, and gender. A nonsignificant lower rate of intubation at birth (2.3% vs 0.6%), admission to neonatal intensive care unit (3.8% vs 3.1%), and meconium aspiration syndrome (1.5% vs 0.6%) were found in period 2 compared with period 1. Only 1 infant died in period 1.
After the implementation of 2015 NRP guidelines, fewer infants were intubated at birth for MSAF. No difference was observed in the rate of associated morbidities and mortality.
A single-center retrospective study of misclassification bias because some of the medical staff started practicing the new guidelines before the official implementation.
None.
2015年，新生儿复苏项目（NRP）指南更新，建议通过胎粪污染羊水（MSAF）娩出的非活力婴儿无需常规插管和气管吸引。
探讨2015年NRP指南对产房管理及通过MSAF出生婴儿结局的影响。
回顾性队列研究。
阿卜杜勒-阿齐兹国王大学医院（KAUH）。
纳入2016年1月1日至2017年12月31日期间在KAUH通过MSAF出生的所有足月儿（孕周大于或等于37周）。根据出生日期将患者分为两组：第1期（2016年1月1日至2016年12月31日），新NRP指南实施前；第2期（2017年1月1日至2017年12月31日），新指南实施后。
通过MSAF出生婴儿的结局。
420例婴儿。
大多数婴儿（n = 261）在第1期出生，159例在第2期出生。两组母亲的预约情况、剖宫产率及医生接生的分娩次数无差异。两组婴儿的孕周、出生体重和性别相似。与第1期相比，第2期出生时插管率（2.3%对0.6%）、入住新生儿重症监护病房率（3.8%对3.1%）和胎粪吸入综合征发生率（1.5%对0.6%）均略低，但差异无统计学意义。第1期仅有1例婴儿死亡。
2015年NRP指南实施后，因MSAF在出生时插管的婴儿减少。相关发病率和死亡率未观察到差异。
单中心回顾性研究存在错误分类偏倚，因为一些医务人员在正式实施前就开始采用新指南。
无。
