Fatal meconium aspiration syndrome occurring despite airway management considered appropriate.

Academic Article

Abstract

  • A combined obstetric-pediatric approach to tracheal toilet is said to prevent serious cases of the potentially fatal meconium aspiration syndrome. After delivery of the head a DeLee trap is used to suction the oropharynx and nasopharynx. Immediately following delivery, endotracheal suction is performed in an effort to remove any remaining meconium-stained amniotic fluid. Although routinely using this approach, we continue to have occasional cases of fatal meconium aspiration syndrome. Therefore, we reviewed the outcome of infants born through meconium-stained fluid. During a 5-year period, 1420 (15%) of 9299 live-born infants had meconium-stained fluid. Thirty (2.1%) of these 1420 developed meconium aspiration syndrome and 12 (40%) died; eight received a postmortem examination. Four had unequivocal evidence of meconium aspiration, two had large numbers of intra-alveolar squamous cells, and two had no evidence of aspiration. We conclude that aggressive airway management during and immediately after delivery does not always prevent fatal meconium aspiration syndrome.
  • Keywords

  • Amniotic Fluid, Delivery, Obstetric, Humans, Infant, Newborn, Intubation, Intratracheal, Lung, Meconium, Persistent Fetal Circulation Syndrome, Pneumonia, Aspiration, Pulmonary Atelectasis, Retrospective Studies, Suction
  • Author List

  • Davis RO; Philips JB; Harris BA; Wilson ER; Huddleston JF
  • Start Page

  • 731
  • End Page

  • 736
  • Volume

  • 151
  • Issue

  • 6