Wilson-Mikity or Meconium Aspiration Syndrome?

In reporting the third case of Wilson-Mikity syndrome in a full-term neonate, Drs. Keidel and Feingold1 appear instead to have described a classic case of meconium aspiration syndrome. Their patient, delivered with difficulty at 41 weeks' gestation, aspirated meconium at the time of delivery and was severely asphyxiated at birth. Respiratory distress developed after resuscitation and the baby was noted to have "diffuse granularity of both lung fields and hyperinflation indicating meconium aspiration." Later, when the chest film showed "hyperexpanded lungs with depressed diaphragms and cyst-like foci alternating with coarse infiltrates" their diagnostic impression apparently changed to Mikity-Wilson syndrome.

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Surfactant Therapy in Full-term Neonates With Severe Respiratory Failure

PEDIATRICS ◽

10.1542/peds.92.1.135 ◽

1993 ◽

Vol 92 (1) ◽

pp. 135-139

Author(s):

Hatem Khammash ◽

Max Perlman ◽

Julian Wojtulewicz ◽

Michael Dunn

Keyword(s):

Respiratory Failure ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Distress Syndrome ◽

Oxygenation Index ◽

Meconium Aspiration Syndrome ◽

Full Term ◽

Surfactant Therapy ◽

Term Infants ◽

Meconium Aspiration

Objective. In light of the paucity of published data on the use of surfactant in full-term infants with respiratory failure due to meconium aspiration syndrome and respiratory distress syndrome, we report our experience with this therapy. Our goal was to explore possible justification for randomized controlled trials of surfactant treatment in similar patients at an earlier, less severe stage of the disease. Methods. Retrospective consecutive case series of 20 infants with severe meconium aspiration syndrome and 29 infants with severe respiratory distress syndrome who received bovine surfactant between March 1990 and December 1992 in three neonatal intensive care units in a regionalized setting. Outcome of treatment was assessed by comparing changes in several respiratory indices including the oxygenation index, between 4 and 6 hours and 1 and 3 hours before and after the first dose of surfactant. Differences were analyzed using analysis of variance for repeated measures, with treatment and time as co-variates. Results. In the meconium aspiration group the mean oxygenation index decreased from 36 ± 12 at 1 to 3 hours presurfactant to 24 ± 14 at 1 to 3 hours postsurfactant (P < .001). In the patients with respiratory distress syndrome the mean oxygenation index fell from 30 ± 17 at 1 to 3 hours presurfactant to 12 ± 6 at 1 to 3 hours postsurfactant (P = .0001). Three of 20 patients with meconium aspiration syndrome and 3 of 29 patients with respiratory distress syndrome received extracorporeal membrane oxygenation. Conclusions. Surfactant therapy in full-term infants with respiratory failure due to the meconium aspiration and respiratory distress syndromes is often effective in improving gas exchange. A randomized controlled trial of surfactant therapy at an earlier stage in the course of the illness should be performed.

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Respiratory Distress Including Meconium Aspiration Syndrome in Vigorous Neonates Born Through Meconium Stained Amniotic Fluid: Incidence, Onset, Severity and Predictors at Birth

The Indian Journal of Pediatrics ◽

10.1007/s12098-012-0914-6 ◽

2012 ◽

Vol 80 (7) ◽

pp. 538-543 ◽

Cited By ~ 4

Author(s):

S. N. Singh ◽

Roli Srivastava ◽

Anita Singh ◽

M. Tahazzul ◽

Mala Kumar ◽

...

Keyword(s):

Respiratory Distress ◽

Amniotic Fluid ◽

Meconium Aspiration Syndrome ◽

Meconium Aspiration ◽

Meconium Stained Amniotic Fluid

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Study of early neonatal outcomes in babies delivered through meconium-stained amniotic fluid in a rural teaching hospital

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20211070 ◽

2021 ◽

Vol 8 (4) ◽

pp. 642

Author(s):

Venkatesh Dhannaram ◽

Sumathi Kotapuri ◽

Sudharshanraj Chitgupikar

Keyword(s):

Respiratory Distress ◽

Amniotic Fluid ◽

Admission Rate ◽

Meconium Aspiration Syndrome ◽

Multiple Gestation ◽

Meconium Aspiration ◽

Emergency Cesarean ◽

Nicu Admission ◽

A Prospective Study ◽

Meconium Stained Amniotic Fluid

Background: When the fetus is in a state of stress meconium is passed presence of meconium in amniotic fluid is potentially a serious Sign of fatal compromise, frequency of meconium strained amniotic fluid ranges from 5-22%. MSAF results in higher rate of cesarean delivery, NICU admission rate, respiratory distress, PPHN and neonatal death. The primary objectives of the study were to estimate the incidence of Meconium aspiration syndrome & Respiratory distress among babies born through meconium-stained amniotic fluid (MSAF) along with studying the outcomes at the end of 7 days.Methods: This was a prospective study undertaken in mediciti institute of medical sciences, Ghanpur Medchal Mandal from Jan 2018 to June 2019. Data was collected in a predetermined proforma after institutional ethical committee clearance and appropriate informed consent.Results: During this period 1972 neonates were delivered of which 216 babies were born through MSAF. 18 were excluded for non-cephalic presentation, multiple gestation or congenital anomalies.198 babies were included in the study (96 male and 102 female). 18 neonates (10.2%) needed resuscitation at birth. 85 (42.9%) had thick MSAF. 43 of them developed respiratory distress (21.7%). 10 babies were ventilated. Seizures, hyperbilirubinemia, thrombocytopenia were more common among babies with thick MSAF. Mortality was 1%.Conclusions: Thick meconium-stained amniotic fluid was associated with low Apgar score, higher rate of emergency cesarean section and meconium aspiration syndrome. Primigravida mothers, maternal hypothyroidism and oligohydramnios were important risk factors associated with MAS.

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The Effects of Different Types of Steroids on Clinical Outcomes in Neonates with Meconium Aspiration Syndrome: A Systematic Review, Meta-Analysis, and GRADE Assessment

Medicina ◽

10.3390/medicina57111281 ◽

2021 ◽

Vol 57 (11) ◽

pp. 1281

Author(s):

Nanthida Phattraprayoon ◽

Teerapat Ungtrakul ◽

Wimonchat Tangamornsuksan

Keyword(s):

Respiratory Distress ◽

Clinical Outcomes ◽

Meta Analysis ◽

Pulmonary Inflammation ◽

Neonatal Morbidity ◽

Meconium Aspiration Syndrome ◽

Cochrane Library ◽

Oxygen Requirement ◽

Meconium Aspiration ◽

Relative Risks

Background and Objectives: Meconium aspiration syndrome (MAS) is a condition caused by the aspiration of meconium-stainted amniotic fluid into the lungs, resulting in pulmonary inflammation, neonatal morbidity, and mortality. It is important that these MAS infants receive appropriate care to avoid further complications. Steroids have an anti-inflammatory effect and may be effective in the management of MAS. The objective of the this study was to evaluate the effect of different steroids on clinical outcomes in infants with MAS. Materials and Methods: We systematically searched of PubMed/Medline, Scopus, Embase, Clinical Trials.gov, and Cochrane Library databases from inception to 24 January 2021 without language restriction. Only randomized controlled trials (RCTs) evaluating the effects of steroids in neonates with MAS were included. We calculated relative risks and weighted mean differences (MDs) with 95% confidence intervals (CIs) using a random-effects model to determine the associations between MAS and steroids and GRADE approach was employed for quality of evidence. The main outcomes measures were duration of respiratory distress, oxygen requirement, hospitalization, need for mechanical ventilation, death, and adverse drug reactions. Results: Seven RCTs involving 397 patients were analyzed. Nebulized budesonide and intravenous (IV) methylprednisolone shortened the duration of respiratory distress (MD, −2.46 days; 95% CI, −3.09 to −1.83 and MD, −3.30 days; 95% CI, −4.07 to −2.52, respectively) (moderate certainty). There was a reduction in duration of oxygen requirement in nebulized budesonide use (MD, −2.40 days; 95% CI, −3.40 to −1.40) (low certainty) and IV methylprednisolone use (MD, −3.30 days; 95% CI, −4.07 to −2.52) (moderate certainty). Nebulized budesonide shortened hospitalization stay (MD, −4.47 days; 95% CI, −8.64 to −0.30 days) (low certainty) as IV methylprednisolone use (MD, −7.23 days; 95% CI, −8.19 to −6.07 days) (moderate certainty). None of steroids benefits in death (low certainty). Conclusions: Certain types of steroids may benefit the respiratory aspect, but there was no decrease in mortality in MAS infants.

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Air Leak Syndrome: Pneumoperitoneum in a Ventilated Neonate

Case Reports in Pediatrics ◽

10.1155/2019/4238601 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4

Author(s):

Chandana Ravikumar ◽

Dawn McDaniel ◽

Amy Quinn

Keyword(s):

Intestinal Perforation ◽

Clinical Evidence ◽

Meconium Aspiration Syndrome ◽

Term Neonate ◽

Air Leak ◽

Air Trapping ◽

Meconium Aspiration ◽

Common Presentation ◽

Free Air ◽

Air Leak Syndrome

Air leak syndrome has several manifestations and is common in neonates with meconium aspiration syndrome (MAS) due to air trapping. While pneumoperitoneum is classically a result of intestinal perforation, intra-abdominal free air may be a less common presentation of air leak syndrome. In the ventilated neonate, there is insufficient clinical evidence outlining management of pneumoperitoneum in this situation. We report a case of a term neonate with MAS and air leak syndrome who developed benign pneumoperitoneum (BPPT).

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Surfactant for meconium aspiration syndrome in full term/near term infants

10.1002/14651858.cd002054.pub2 ◽

2007 ◽

Cited By ~ 43

Author(s):

Amr I El Shahed ◽

Peter A. Dargaville ◽

Arne Ohlsson ◽

Roger Soll

Keyword(s):

Meconium Aspiration Syndrome ◽

Full Term ◽

Term Infants ◽

Meconium Aspiration ◽

Near Term

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Postnatal causes and severity of persistent pulmonary Hypertension of Newborn

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.37.5.2218 ◽

2021 ◽

Vol 37 (5) ◽

Author(s):

Muhammad Sohail Arshad ◽

Mudasser Adnan ◽

Hafiz Muhammad Anwar-ul-Haq ◽

Arif Zulqarnain

Keyword(s):

Pulmonary Hypertension ◽

Respiratory Distress Syndrome ◽

Respiratory Distress ◽

Gestational Age ◽

Distress Syndrome ◽

Birth Asphyxia ◽

Meconium Aspiration Syndrome ◽

Persistent Pulmonary Hypertension ◽

High Morbidity ◽

Meconium Aspiration

Background & Objective: Persistent pulmonary hypertension of the newborn (PPHN) is described as severe respiratory failure along with hypoxaemia. PPHN is known to be linked with high morbidity and mortality around the world. This study was planned to determine the postnatal causes and assess the severity of persistent pulmonary hypertension of newborn in babies presenting to the Children’s Hospital, Multan. Methods: This observational study was conducted at the Department of Paediatric Cardiology, The Children Hospital &Institute of Child Health, Multan, Pakistan from July to December 2019. A total of 122 confirmed cases of PPHN admitted having gestational age above 34 weeks were enrolled. Demographic data of the newborns was recorded along with maternal medical history, pregnancy status and postnatal causes of PPHN. Severity of PPHN was also recorded. Results: Out of a total of 122 cases of PPHN, 81 (66.3%) were male. Majority, 78 (64.0%) had gestational age above 37 weeks. Mode of delivery as cesarean section was noted in 70 (57.4%). Meconium aspiration syndrome 52 (42.6%), birth asphyxia 48 (39.3%), respiratory distress syndrome 23 (18.8%) and sepsis 33 (27.0%) were found to be the commonest causes of PPHN. Severe PPHN was found to be the most frequent, noted among 63 (51.6%) while Moderate PPHN was observed in 40 (32.8%) and Mild PPHN in 19 (15.6%). Morality was noted among 26 (21.3%) of cases. Conclusion: Meconium aspiration syndrome, birth asphyxia and respiratory distress syndrome were the commonest postnatal causes of PPHN. Severe PPHN was found to be the most frequent form of PPHN. doi: https://doi.org/10.12669/pjms.37.5.2218 How to cite this:Arshad MS, Adnan M, Anwar-ul-Haq HM, Zulqarnain A. Postnatal causes and severity of persistent pulmonary Hypertension of Newborn. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.2218 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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