EFFECT OF ENDOTRACHEAL INTUBATION AND SUCTION AT BIRTH FOR PREVENTING MORBIDITY AND MORTALITY IN MECONIUM ASPIRATION SYNDROM

Meconium-stained amniotic fluid (MSAF) occurs in approximately 5-20% of live births that meconium aspiration syndrome occurs in approximately 4-5% of these neonates after birth with breathing meconium goes to the small bronchial tree and clinical manifestation such as respiratory distress and tachypena, is present. Thease patients have high mortality and morbidity. For this reason, we studied two groups of infants with meconium stained fluid and compaired mortality and morbidity in two groups. One group was intubated and suction immediately after, and other group was not intubated. In this study, that was prospective and analytical cross-sectional, infants who were delivered with meconium-stained amniotic fluid (MSAF) throught a 3 years period (1996-1999) AkbarAbadi Hospital were studied. In this period 33037 infants were delivered and meconium-stained amniotic fluid (MSAF) occurred in 3254 (9.85%) of this live births. In 217 instance (6.67%) amniotic fluid was thick, in 188 (86.64%) of this infants the trachea was immediately. After birth intubated and suctioned. But unfortunately in 29 infants (13.36%). The trachea was not immediately after birth intubated and suctioned. In the intubated group complications included: Sepsis 17.55% (25 patients), pneumothorax 13.82% (26 patients), respiratory distress syndrome (RDS) 15.42% (29 patients), peresistent fetal circulation (PFC) 3.19% (6 patient). In 29 infants (13.36%) that we couldn’t intubated and suctioned, complications included: sepsis 10.34% (3 infants), pneumothorax 37.93% (11 infants), RDS 17.24% (5 infants), PFC 6.9% (2 infants). In all in intubated group complications were in 45.74% (86 infants) that 6.38% (12 infants) of this were died. In unintubated group, complications were seen in 72.41% (21 infants), that 13.79% (4 infants) were died. In this study intubation and suction immediately after birth in thick meconium-stained amniotic fluid decreased meconium Aspiration syndrome but increased it’s morbidity.