neonatal swallowing syndrome
Introduction
Introduction to neonatal swallowing syndrome Neonatal swallowing syndrome is not uncommon in the neonatal period, and is more common in neonates with dystocia, asphyxia or expired history. The main feature is that a large amount of amniotic fluid is swallowed, vomiting occurs after birth, vomiting is aggravated after eating, vomiting is amniotic fluid, blood can also be taken, and self-healing after 1 to 2 days. basic knowledge Sickness ratio: 5% Susceptible people: children Mode of infection: non-infectious Complications: dehydration, electrolyte imbalance, aspiration pneumonia, neonatal asphyxia
Cause
Causes of neonatal swallowing syndrome
(1) Causes of the disease
Under normal circumstances, the fetus can swallow a small amount of amniotic fluid in the uterus, which is not irritating to the fetal gastric mucosa, but during the delivery process, the fetus is swallowed with too much amniotic fluid, or swallowed by meconium or infected. Neonatal swallowing syndrome can occur in amniotic fluid, or amniotic fluid containing more maternal blood.
(two) pathogenesis
Because a large amount of amniotic fluid is swallowed, or amniotic fluid has been infected, it can stimulate the neonatal gastric mucosa, causing gastric acid and mucus secretion and causing vomiting.
Prevention
Neonatal swallowing syndrome prevention
Do a good job in perinatal health care to prevent dystocia, intrauterine asphyxia and overdue production, improve the level of delivery technology, and prevent excessive amniotic fluid.
Complication
Neonatal swallowing syndrome complications Complications dehydration electrolyte disorder aspiration pneumonia neonatal asphyxia
In severe cases, there may be dehydration and electrolyte imbalance, and inhalation of vomit may cause aspiration pneumonia and even suffocation.
Symptom
Symptoms of neonatal swallowing syndrome common symptoms meconium contamination eating vomiting black pharyngeal reflex
Often vomiting is started after the birth, and the vomiting is foamy mucus, sometimes with green color. It is amniotic fluid contaminated by meconium, sometimes containing brown blood samples. Vomiting is often aggravated after starting feeding, and spit out after milking, but The general condition is normal, no cough, no cyanosis and other symptoms, meconium discharge is normal, sometimes black stools, fecal occult blood positive, physical examination abdominal distension, no stomach or intestinal type, no other abnormal signs, usually Within 1 to 2 days, the swollen amniotic fluid and the contents of the birth canal and the blood are spit out, and vomiting stops.
Examine
Examination of neonatal swallowing syndrome
General laboratory examination of mild cases, such as pneumonia or swallowed contaminated amniotic fluid, may have peripheral blood leukocytosis, fecal occult blood positive; severe disease may have water, electrolyte balance disorder, should be blood sodium, potassium, chlorine, calcium and Blood pH check.
Imaging examination should be performed, except for gastrointestinal malformations, and chest radiographs should be followed for aspiration pneumonia.
Diagnosis
Diagnosis and diagnosis of neonatal swallowing syndrome
After eating, he has started vomiting. The content of vomiting is green mucus, or blood, dystocia, suffocation or expired history. It is the diagnosis point of this disease and excludes congenital gastrointestinal malformations, such as esophagus and intestinal atresia.
When the amount of vomiting is high, it needs to be differentiated from the neonatal gastrointestinal hemorrhage. For example, neonatal stress ulcer, neonatal hemorrhagic disease, or hematemesis symptoms, can do APT test, take vomit or stool blood samples, add water Stir well, make it hemolyze, after sedimentation, take 5 parts of clear liquid and add 1 part of 1% sodium hydroxide, observe after 1~2min, if it is brownish yellow, it means blood comes from the mother, because adult hemoglobin is denatured when it is alkali, if it is Red indicates that the blood comes from the newborn itself. Because the neonatal blood is mainly fetal hemoglobin, it has anti-alkaline and does not change color. After the above test, if it is proved to be maternal blood, it can be diagnosed as the disease.
