Meconium aspiration syndrome - the experience of a tertiary center [Síndrome de aspiração meconial - experiência de um centro terciário]

Background: approximately 5 % of infants born with a meconium-stained amniotic fluid (msaf) develop meconium aspiration syndrome (mas). aim: the aims of this study were to analyse demographic data,morbidity and mortality associated with mas and to identify possible risk factors. methods: retrospective chart review of newborns with mas delivered at a tertiary center from january 1st,1997 to december 31st,2008. results: mas was responsible for 1.4 % of all neonatal intensive care unit (nicu) admissions,with a trend towards a decreasing incidence during the duration of the study,especially in the cases of thin meconium. seventy two newborns were analysed during the study period: 55.6 % (n = 40) were of the female gender,62.5 % were delivered by caesarean section,93 % had > 36 weeks of gestational age and 91.2 % had a birth weight over 2500 g. sixty-nine percent had an apgar score < 7 at 1 minute and 23.6 % an apgar score < 7 at 5 minutes; foetal bradicardia was present in 26.4 % of the newborns and tachycardia in 1.4 %. the presence of meconium was associated with severe asphyxia and carried a bad prognosis with an increased risk of developing hypoxia (58.3 %),need of mechanical ventilatory support (43.1 %),respiratory and/or metabolic acidosis (30.6 %),pulmonary hypertension (11.1 %) and hypoxic ischemic encephalopathy (29.2 %). the mortality rate was 2.8 %. thick meconium was associated with higher morbidity and mortality rates. conclusions: the number of admissions for mas has been decreasing mostly because of a lower admission rate due to thin meconium; the number of cases with thick meconium has remained constant throughout the years. an apgar score < 7 at 1 minute and signs of foetal distress during labour were associated with mas. the mas related morbidity remains signifi cant. © 2010 published by elsevier españa,s.l. on behalf of sociedade portuguesa de pneumologia.