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Meconium aspiration syndrome

最后审阅: 13 Nov 2025
最后更新: 05 Apr 2024

小结

定义

病史和体格检查

关键诊断因素

  • signs of postmaturity
  • tachypnea
  • cyanosis
  • chest wall asymmetry with decreased air entry
  • barrel-shaped chest
完整详情

其他诊断因素

  • grunting
  • chest retractions
  • rales
  • rhonchi
  • tachycardia
  • hypotension
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危险因素

  • gestational age >42 weeks
  • pregnancy-induced hypertension
  • maternal diabetes mellitus
  • maternal smoking or substance misuse
  • fetal distress
  • oligohydramnios
  • thick meconium
  • Apgar score <7
  • chorioamnionitis
  • cesarean delivery
  • black ancestry
  • male sex
完整详情

诊断性检查

首要检查

  • CXR
  • CBC
  • CRP
  • blood culture
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需考虑的检查

  • dual pulse oximetry
  • ABG (pH, PaO₂, PaCO₂)
  • echocardiography
  • cranial ultrasound
  • electroencephalogram
  • urinalysis
完整详情

治疗流程

急症处理

vigorous infant born through meconium-stained amniotic fluid, no respiratory distress

mild MAS

moderate MAS

severe MAS

撰稿人

作者

Dharmapuri Vidyasagar, MD, MSc, FAAP, FCCM, PhD (Hon)
Dharmapuri Vidyasagar

Professor Emeritus

Department of Pediatrics

University of Illinois at Chicago

Chicago

IL

Visiting Professor

Department of Neonatology

Sri Ramachandra Medical College

Chennai

India

利益声明

DV is an author of a number of references cited in this topic. He has received royalties for editing the following books: Neonatal Ventilation (Elsevier India), Practical Neonatology (Indian Journal of Pediatrics), and Perinatal Cardiology (Cambridge Scholar publishing).

Rama Bhat, MD, FAAP

Professor of Pediatrics

Department of Pediatrics

University of Illinois at Chicago

Chicago

IL

利益声明

RB is an author of a reference cited in this topic.

同行评议者

Ahmed Osman, MD

Assistant Professor of Pediatrics

Attending Neonatologist

Department of Pediatrics

The Ohio State University and Nationwide Children’s Hospital

Columbus

OH

利益声明

AO is an author of a reference cited in this topic.

Henry L. Halliday, MD, FRCPE, FRCP, FRCPCH

Professor

Retired Consultant Neonatologist

Royal Maternity Hospital

Honorary Professor

Department of Child Health

Queen's University Belfast

Belfast

UK

利益声明

HLH declares that he has no competing interests.

John Sinn, MBBS(Syd), Dip Paed, DCH, MMed (Clin Epi), FRACP (Paed)

Clinical Senior Lecturer

Obstetrics

Gynaecology and Neonatology

Royal North Shore Hospital and The University of Sydney

Sydney

Australia

利益声明

JS declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

Thornton PD, Campbell RT, Mogos MF, et al. Meconium aspiration syndrome: incidence and outcomes using discharge data. Early Hum Dev. 2019 Sep;136:21-6. 摘要

Singh BS, Clark RH, Powers RJ, et al. Meconium aspiration syndrome remains a significant problem in the NICU: outcomes and treatment patterns in term neonates admitted for intensive care during a ten-year period. J Perinatol. 2009 Jul;29(7):497-503. 摘要

Vidyasagar D, Harris V, Pildes RS. Assisted ventilation in infants with meconium aspiration syndrome. Pediatrics. 1975 Aug;56(2):208-13. 摘要

Wiswell TE, Gannon CM, Jacob J, et al. Delivery room management of the apparently vigorous meconium-stained neonate: results of the multicenter, international collaborative trial. Pediatrics. 2000 Jan;105(1 Pt 1):1-7. 摘要

Yamada NK, Szyld E, Strand ML, et al. 2023 American Heart Association and American Academy of Pediatrics focused update on neonatal resuscitation: an update to the American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2024 Jan 2;149(1):e157-66.全文  摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Meconium aspiration syndrome images
  • 鉴别诊断

    • Transient tachypnea of the newborn
    • Surfactant deficiency
    • Persistent pulmonary hypertension
    更多 鉴别诊断
  • 指南

    • 2023 American Heart Association and American Academy of Pediatrics focused update on neonatal resuscitation: An update to the American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care
    • Management of meconium at birth
    更多 指南
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