Yong Y P, Ho L Y
Department of Neonatology, Singapore General Hospital, Singapore.
Singapore Med J. 1997 May;38(5):205-8.
To review the incidence, morbidity and mortality of Meconium Aspiration Syndrome (MAS). To identify possible predictors of MAS in newborns with thick meconium-stained amniotic fluid (MSAF) at delivery.
Case records of babies with MSAF delivered in Singapore General Hospital from 1.1.1991 to 31.12.1993 were studied retrospectively.
In the study period, 1,893 babies (15% of live births) had MSAF and 174 babies (1.4% live births) developed MAS. The incidences of MAS in newborns with light, moderate and thick MSAF were 0.3%, 5.8% and 61% respectively. Complications associated with MAS were metabolic acidosis (52%), air leak syndrome (2%), persistent pulmonary hypertension (2%) and hypoxic ischaemic encephalopathy (0.5%). The mortality rate of babies with MAS was 2%. Newborns with thick MSAF were more likely to develop MAS if they were males, small-for- gestational-age, had fetal distress and meconium was sucked from the trachea at birth.
Vigilant perinatal monitoring of high risk babies with MSAF and proper resuscitation at birth would help reduce the incidence of MAS and its associated complications.
回顾胎粪吸入综合征（MAS）的发病率、发病率和死亡率。确定分娩时羊水重度胎粪污染（MSAF）的新生儿中MAS的可能预测因素。
回顾性研究1991年1月1日至1993年12月31日在新加坡总医院分娩的MSAF婴儿的病例记录。
在研究期间，1893例婴儿（占活产的15%）有MSAF，174例婴儿（占活产的1.4%）发生MAS。轻度、中度和重度MSAF新生儿的MAS发病率分别为0.3%、5.8%和61%。与MAS相关的并发症有代谢性酸中毒（52%）、气漏综合征（2%）、持续性肺动脉高压（2%）和缺氧缺血性脑病（0.5%）。MAS婴儿的死亡率为2%。重度MSAF新生儿如果是男性、小于胎龄儿、有胎儿窘迫且出生时从气管吸出胎粪，则更有可能发生MAS。
对MSAF高危婴儿进行围产期密切监测并在出生时进行适当复苏，将有助于降低MAS及其相关并发症的发生率。
