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ANALYSIS OF CLINICAL CHARACTERISTICS AND DEATH RELATED FACTORS OF SEVERE MECONIUM ASPIRATION SYNDROME -- A MULTI-CENTER RETROSPECTIVE SURVEY

Zhu JX¹, Sun B² Zhou XL¹, Zhang XD², Sun MY³, Zhang YM⁴, Shen YH⁵ , Song SM⁶ , Chen KZ⁷, Gan XG⁸ , Song GW ⁸

¹Xinhua Hospital, Shanghai Second Medical University; Shanghai, China

^2-8 Collaborative Centers, Shanghai, Beijing, Hangzhou, Nanjing and Guangzhou, China

Objectives: To investigate the factors in relation with the case fatality in severe meconium aspiration syndrome (MAS).

Methods: Eighty-one of severe MAS cases manifested serious respiratory distress, cyanosis and appearing evidence of MAS from chest roentgenograph and intervened by the mechanical ventilation from 9 children’s hospitals were retrospectively analyzed for the risk factors of fatality with SAS software for non-parametric rank sum test and chi-square test.

Results: Forty-nine were survived among 81 cases (death rate: 39%). GA, 1 minute Apgar’s score and complications (PPPH, HIE and pneumothorax) with MAS were significantly related to the death (p< 0.05). There was no difference of death rate between the patients with or without receiving endotracheal intubation and airway suctioning at birth (p >0.05).

Conclusion: A higher death rate (close to 40%) of severe MAS in the middle of 1990’s in major cities of China suggests that effects of delivery room suction and conventional ventilation need to be reevaluated.