Typing characteristics and determining indicators of severe meconium aspiration syndrome

Abstract

Objective To investigate the characteristics of different clinical types of severe meconium aspiration syndrome (MAS), and provide a scientific basis for classification of severe MAS by the disease treatment. Methods From January 2008 to December 2011, a total of 236 hospitalized cases who were diagnosed with severe MAS in Suizhou Maternal and Child Health Hospital Center were included in the study.They were divided into heavy MAS group(n=158) and critical MAS group(n=78). There were no statistically significant differences in gender constituent ratio, gestational age, birth weight between two groups(P>0.05). With the same method, another 127 hospitalized case were also chosen in the study from January 2012 to December 2013, and they were divided into verification of heavy MAS group(n=88) and verification of critical MAS group(n=39). There were no statistically significant differences in gender constituent ratio, gestational age between two groups either(P>0.05). The clinical manifestations, laboratory examination results, auxiliary examination results, complications and prognosis were observed.The results of single factor analysis was statistically significant for multi-factor unconditioned logistic regression analysis. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Suizhou Maternal and Child Health Hospital. Informed consent was obtained from each participants' parents. Results There were significant differences in 7 kinds of clinical manifestations such as coma, convulsions, breathing difficulties, the duration of cyanosis ≥3 d and so on between two groups(P 60 mmHg, pH value 65 mmHg, lung gas leakage were the independent forecasts determine index of critical intensive MAS .The results of prospective Kappa test in two verification groups showed that Youden index was 0.95, Kappa value was 0.945, and its sensitivity was 0.97, specificity was 0.98. Conclusions The children with the duration of breathing difficulties and cyanosis ≥3 days, arterial blood PaCO2>65 mmHg, lung gas leakage can be diagnosed as critical intensive MAS. Key words: Meconium aspiration syndrome; Typing characteristics; Referrence standard