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Síndrome de aspiração meconial - experiência de um centro terciário
Meconium aspiration syndrome - the experience of a tertiary center
M.C. Espinheira, M. Grilo, G. Rocha
, B. Guedes, H. Guimarães
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Serviço de Cuidados Intensivos Neonatais, Departamento de Pediatria. Hospital São João, Porto, Portugal
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Pinto, C. Couto Sant’Anna, M. Bernhoeft" "autores" => array:4 [ 0 => array:2 [ "nombre" => "M.A." "apellidos" => "Rocha Crispino Santos" ] 1 => array:2 [ "nombre" => "M.L." "apellidos" => "Pinto" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Couto Sant’Anna" ] 3 => array:2 [ "nombre" => "M." "apellidos" => "Bernhoeft" ] ] ] ] ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0873215911700162?idApp=UINPBA00004E" "url" => "/08732159/0000001700000002/v2_201509070838/S0873215911700162/v2_201509070838/pt/main.assets" ] "pt" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Artigo original</span>" "titulo" => "Síndrome de aspiração meconial - experiência de um centro terciário" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "71" "paginaFinal" => "76" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "M.C. Espinheira, M. Grilo, G. Rocha, B. Guedes, H. Guimarães" "autores" => array:5 [ 0 => array:2 [ "nombre" => "M.C." "apellidos" => "Espinheira" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Grilo" ] 2 => array:4 [ "nombre" => "G." "apellidos" => "Rocha" "email" => array:1 [ 0 => "gusrocha@oninet.pt" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 3 => array:2 [ "nombre" => "B." "apellidos" => "Guedes" ] 4 => array:2 [ "nombre" => "H." "apellidos" => "Guimarães" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Serviço de Cuidados Intensivos Neonatais, Departamento de Pediatria. Hospital São João, Porto, Portugal" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Autor para correspondência." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Meconium aspiration syndrome - the experience of a tertiary center" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2009-10-07" "fechaAceptado" => "2010-08-31" "PalabrasClave" => array:2 [ "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec566808" "palabras" => array:4 [ 0 => "Síndrome de aspiração meconial" 1 => "Factores de risco" 2 => "Morbilidade" 3 => "Mortalidade" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec566809" "palabras" => array:4 [ 0 => "Meconium aspiration syndrome" 1 => "Risk factors" 2 => "Morbidity" 3 => "Mortality" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<span><span class="elsevierStyleSectionTitle">Introdução</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Aproximadamente 5% dos recém-nascidos com evidência de mecónio no líquido amniótico desenvolvem a síndrome de aspiração meconial (SAM).</p></span> <span><span class="elsevierStyleSectionTitle">Objectivos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Conhecer os dados demográficos, a morbilidade e mortalidade na dependência da SAM e identificar possíveis factores de risco.</p></span> <span><span class="elsevierStyleSectionTitle">Métodos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleItalic">:</span> Estudo retrospectivo dos recém-nascidos com SAM nascidos num hospital terciário entre 1 de Janeiro de 1997 e 31 de Dezembro de 2008.</p></span> <span><span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A SAM foi responsável por 1,4% das admissões na Unidade de Cuidados Intensivos Neonatais (UCIN), verificando-se uma tendência para o decréscimo no número de internamentos ao longo dos anos, principalmente dos casos com líquido amniótico tingido de mecónio. No período de estudo foram analisados 72 recém-nascidos: 55,6% do sexo feminino, 62,5% com parto por cesariana, 93% com idade gestacional > 36 semanas e 91,2% com peso ao nascimento > 2500<span class="elsevierStyleHsp" style=""></span>g. 69% dos recém-nascidos apresentaram Índice de Apgar < 7 no 1. ° minuto e 23,6% Índice de Apgar < 7 no 5.° minuto; bradicardia fetal foi observada em 26,4% dos recém-nascidos e taquicardia em 1,4%. A presença de mecónio no líquido amniótico condicionou o desenvolvimento de hipóxia (58,3%), necessidade de ventilação mecânica (43,1%), acidose respiratória e/ou metabólica (30,6%), hipertensão pulmonar (11,1%) e encefalopatia hipóxico-isquémica (29,2%). A taxa de mortalidade foi de 2,8%. A presença de mecónio espesso esteve associada a maiores taxas de morbilidade e mortalidade.</p></span> <span><span class="elsevierStyleSectionTitle">Conclusão</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">O número de internamentos por SAM tem vindo a diminuir principalmente devido ao decréscimo das admissões por líquido amniótico tingido de mecónio, enquanto o número de casos de mecónio espesso tem permanecido constante ao longo dos anos. O Índice de Apgar < 7 no 1. ° minuto e a presença de sinais de sofrimento fetal durante o trabalho de parto apresentaram relação com a SAM. A morbilidade associada à SAM permanece significativa.</p></span>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span><span class="elsevierStyleSectionTitle">Background</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Approximately 5% of infants born with a meconium-stained amniotic fluid (MSAF) develop meconium aspiration syndrome (MAS).</p></span> <span><span class="elsevierStyleSectionTitle">Aim</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The aims of this study were to analyse demographic data, morbidity and mortality associated with MAS and to identify possible risk factors.</p></span> <span><span class="elsevierStyleSectionTitle">Methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Retrospective chart review of newborns with MAS delivered at a tertiary centre from January 1<span class="elsevierStyleSup">st</span>, 1997 to December 31<span class="elsevierStyleSup">st</span>, 2008.</p></span> <span><span class="elsevierStyleSectionTitle">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">MAS was responsible for 1.4% of all Neonatal Intensive Care Unit (NICU) admissions, with a trend towards a decreasing incidence during the study duration, especially in the cases of thin meconium. Seventy two newborns were analysed during the study period: 55.6% (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>40) were of the female gender, 62.5% were delivered by caesarean section, 93% had > 36 weeks of gestational age and 91.2% had a birth weight over 2500<span class="elsevierStyleHsp" style=""></span>g. Sixty-nine percent had an Apgar score < 7 at 1 minute and 23.6% an Apgar score < 7 at 5 minutes; foetal bradicardia was present in 26.4% of the newborns and tachycardia in 1.4%. The presence of meconium was associated with severe asphyxia and carried a bad prognosis with an increased risk of developing hypoxia (58.3%), need of mechanical ventilatory support (43.1%), respiratory and/or metabolic acidosis (30.6%), pulmonary hypertension (11.1%) and hypoxic ischemic encephalopathy (29.2%). The mortality rate was 2.8%. Thick meconium was associated with higher morbidity and mortality rates.</p></span> <span><span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">The number of admissions for MAS has been decreasing mostly because of a lower admission rate due to thin meconium; the number of cases with thick meconium has remained constant throughout the years. An Apgar score < 7 at 1 minute and signs of foetal distress during labour were associated with MAS. The MAS related morbidity remains significant.</p></span>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografia" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:14 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." 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Goldsmith" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/jp.2008.156" "Revista" => array:6 [ "tituloSerie" => "J Perinatol" "fecha" => "2008" "volumen" => "28" "paginaInicial" => "S49" "paginaFinal" => "S55" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19057611" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Surfactant-replacement therapy for respiratory distress in the preterm and term neonate" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "the Committee on Fetus and Newborn" "etal" => false "autores" => array:1 [ 0 => "W.A. 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Article information
ISSN: 08732159Original language: Portuguese
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