Suresh G K, Sarkar S
Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh.
Indian Pediatr. 1994 Oct;31(10):1177-81.
A total of 3472 deliveries were studied over a year to evaluate (i) the importance of thin meconium stained liquor (MSL) in the causation of meconium aspiration syndrome (MAS), and (ii) the efficacy of intrapartum plus endotracheal suction at birth in the prevention of MAS due to thin meconium. Two hundred and ninety four (8.5%) of deliveries had meconium stained liquor of which thin MSL was present in 101. MAS occurred in 98 babies. Thin MSL was responsible for 19.4% of cases of MAS. Inspite of intrapartum suction, a high proportion (55-78%) of infants had meconium in the trachea, though thin meconium was found in the trachea significantly less often than thick meconium. Combined intrapartum and endotracheal suction reduced the incidence of MAS due to thin meconium from 26% to 16%. MAS due to thin meconium occurred in asphyxiated as well as vigorous babies inspite of combined suction. Thin meconium accounts for a significant proportion of deliveries with MSL and causes a considerable number of cases of MAS. To prevent meconium aspiration syndrome caused by thin meconium, all neonates born through thin MSL, whether they are asphyxiated or not should undergo intrapartum suction followed by immediate endotracheal suction at birth.
在一年的时间里，共对3472例分娩进行了研究，以评估：（i）稀薄胎粪污染羊水（MSL）在胎粪吸入综合征（MAS）病因中的重要性；（ii）产时加出生时气管内吸引预防稀薄胎粪所致MAS的效果。294例（8.5%）分娩的羊水被胎粪污染，其中101例存在稀薄MSL。98例婴儿发生了MAS。稀薄MSL导致了19.4%的MAS病例。尽管进行了产时吸引，但仍有很大比例（55 - 78%）的婴儿气管内有胎粪，不过气管内发现稀薄胎粪的情况明显少于浓稠胎粪。产时和气管内联合吸引使稀薄胎粪所致MAS的发生率从26%降至16%。尽管进行了联合吸引，稀薄胎粪所致MAS仍发生在窒息和活力良好的婴儿中。稀薄胎粪在羊水被胎粪污染的分娩中占很大比例，并导致相当数量的MAS病例。为预防稀薄胎粪所致的胎粪吸入综合征，所有经稀薄MSL出生的新生儿，无论是否窒息，均应在产时进行吸引，随后在出生时立即进行气管内吸引。
