Hernandez et al reported predictors for severe meconium aspiration syndrome in a neonate. These can help to identify a neonate who may require more aggressive management. The authors are from the University of Texas Southwestern Medical Center in Dallas.

Patient selection: neonate with meconium aspiration syndrome


Predictors for neonatal ventilation:

(1) fetal tachycardia

(2) interval from meconium detection to delivery

(3) low 5-minute Apgar score

(4) respiratory distress requiring intubation in the delivery suite

(5) delivery by cesarean section


Predictors of prolonged ventilation:

(1) ominous fetal heart rate tracing

(2) umbilical arterial pH < 7.2

(3) macrosomia (birth weight > 90th percentile)

(4) nulliparity

(5) Apgar > 4 at 1 minute

(6) Apgar <= 6 at 5 minutes



The risk factors of Apgar > 4 at 1 minute and <= 6 minutes at 5 minutes need to be resolved.

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