Abstract:
MAS is a common cause of neonatal respiratory distress in term and post-term neonates. Meconium staining of the amniotic fluid occurs in about 10-13% of normal pregnancies, and about 4% of these infants develop respiratory distress. In the past, MAS was diagnosed mainly on the basis of history, clinical symptoms, and chest radiography. Several authors have addressed the ultrasonographic assessment of the most common respiratory patterns in neonates. In particular, MAS is characterised by a heterogeneous alveolointerstitial syndrome, subpleural abnormalities with multiple lung consolidations, characterised by a hepatisation aspect. We present six cases of infants with a clinical history of meconium-stained fluid who presented with respiratory distress at birth. Lung ultrasound allowed the diagnosis of MAS in all the studied cases, despite the mild clinical picture. All children had the same ultrasound pattern with diffuse and coalescing B-lines, pleural line anomalies, air bronchograms, and subpleural consolidations with irregular shapes. These patterns were distributed in different areas of the lungs. These signs are specific enough to distinguish between MAS and other causes of neonatal respiratory distress, allowing the clinician to optimise therapeutic management.
摘要:
MAS是足月和足月新生儿呼吸窘迫的常见原因。羊水的胎粪染色发生在约10-13%的正常妊娠中,这些婴儿中约有4%出现呼吸窘迫。在过去,MAS的诊断主要是根据病史,临床症状,和胸部X线照相.几位作者已经讨论了新生儿最常见呼吸模式的超声检查评估。特别是,MAS的特征是异质性肺泡间质综合征,胸膜下异常伴多发性肺巩固,以肝化方面为特征。我们介绍了6例具有胎粪染色液临床病史的婴儿,这些婴儿在出生时出现呼吸窘迫。肺部超声检查允许在所有研究病例中诊断MAS,尽管临床表现温和。所有孩子都有相同的超声模式,有弥散和合并的B线,胸膜线异常,空气支气管图,和不规则形状的胸膜下合并。这些模式分布在肺的不同区域。这些体征的特异性足以区分MAS和新生儿呼吸窘迫的其他原因,允许临床医生优化治疗管理。