Tantu Temesgen, Zewdu Dereje, Degemu Fikretsion, Yehualeshet Tsiyon
Obstetrics and Gynecology, Wolkite University College of Medicine and Health Sciences, Wolkite, Ethiopia.
Anesthesia, Wolkite University College of Medicine and Health Sciences, Wolkite, Ethiopia.
Front Pediatr. 2023 Mar 23;11:1149398. doi: 10.3389/fped.2023.1149398. eCollection 2023.
Meconium aspiration syndrome is respiratory distress diagnosed in neonates delivered with meconium-stained amniotic fluid that is unexplained by other pathologies. It has severe neonatal respiratory complications and a significant impact on the prevalence of neonatal mortality.
To identify the incidence and determinants associated with meconium aspiration syndrome among mothers with meconium-stained amniotic fluid after emergency cesarean section in Wolkite University specialized hospitals in Ethiopia from September 1, 2021, to August 30, 2022.
An institution-based cross-sectional study was done prospectively through meticulous chart review and interviews with 275 mothers with meconium-stained amniotic fluid who gave birth with an emergency cesarean section. Data were entered using EpiData 7 and analyzed with SPSS 26. The association between independent variables and the meconium-aspiration syndrome was estimated using an odds ratio with 95% confidence intervals. The statistical significance of the association was declared at a -value of 0.05.
The prevalence of the meconium-aspiration syndrome is 28.7%. The factors associated are: latent phase (AOR: 2.580; 95% CI: 1.126, 5.913), low 1st minute APGAR score (AOR: 2.43; 95% CI: 0.892, 6.625), and thick meconium (AOR: 31.018; 95% CI: 9.982, 96.390). The neonatal death rate associated with meconium aspiration syndrome is 1.8%, and thick meconium contributed to 65% of admissions to the neonatal intensive care unit and all deaths.
The incidence of meconium aspiration syndrome is high, and thick meconium, meconium at early labor, and low APGAR scores all contributed to this. Thick meconium has a substantial effect on neonatal mortality and morbidity. Therefore, an improvement in the quality of obstetric and neonatal care through early intervention in the case of thick meconium and meconium in the early phase of labor is recommended.
胎粪吸入综合征是指在羊水被胎粪污染的新生儿中诊断出的呼吸窘迫，且无法用其他病理情况解释。它会引发严重的新生儿呼吸并发症，并对新生儿死亡率产生重大影响。
确定2021年9月1日至2022年8月30日在埃塞俄比亚沃尔基特大学专科医院行急诊剖宫产术后羊水被胎粪污染的母亲中胎粪吸入综合征的发生率及相关决定因素。
通过细致的病历审查和对275例羊水被胎粪污染且行急诊剖宫产的母亲进行访谈，开展了一项基于机构的前瞻性横断面研究。数据使用EpiData 7录入，并采用SPSS 26进行分析。使用比值比及95%置信区间评估自变量与胎粪吸入综合征之间的关联。关联的统计学显著性以P值0.05确定。
胎粪吸入综合征的患病率为28.7%。相关因素包括：潜伏期（比值比：2.580；95%置信区间：1.126，5.913）、1分钟阿氏评分低（比值比：2.43；95%置信区间：0.892，6.625）以及胎粪黏稠（比值比：31.018；95%置信区间：9.982，96.390）。与胎粪吸入综合征相关的新生儿死亡率为1.8%，胎粪黏稠导致65%的新生儿重症监护病房入院病例及所有死亡病例。
胎粪吸入综合征的发生率较高，胎粪黏稠、产程早期出现胎粪以及阿氏评分低均对此有影响。胎粪黏稠对新生儿死亡率和发病率有重大影响。因此，建议在胎粪黏稠及产程早期出现胎粪的情况下通过早期干预来提高产科和新生儿护理质量。
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