Meconium Aspiration Syndrome

MECONIUM ASPIRATION SYNDROME
  • Meconium aspiration syndrome occurs when infants take meconium into their lungs during or before delivery
Incidence
  • Incidence 10-15%; Usually in term or post term and small for date babies
Clinical Feature
  • Meconium stooling is seen in 90 percent of newborns within the first 24 hours, and most of the rest within 36 hours.
  • Patient with leakage of fluid and meconium stained liquor at 34 weeks of gestation is suffering from preterm premature rupture of membrane (PROM)
  • Either in utero or with the first breath, thick, particulate meconium is aspirated into the lungs
  • These babies usually develop respiratory distress in the first few hours of life

  • Meconium is excreted by a new born till 3 day
Saffron coloured meconium is seen in post maturity.
Content
  • Meconium contains -
i) Intestinal epithelial cells iii) Mucus v) Bile
ii) Lanugo iv) Amniotic fluid vi) Water
Diagnosis
  • Meconium stained liquor (amniotic fluid) with respiratory distress soon after birth suggests the diagnosis of meconium aspiration syndrome
  • Chest X-ray: bilateral heterogeneous opacities (patchy infiltrates), coarse streaking of both lung fields, areas of hyper expansion, atelectasis and air leak, increased AP diameter, flattening of diaphragm
Complication
  • Complications: Persistent pulmonary hypertension
  • Obstructive emphysema can occur as a result of passage of meconium in utero.
  • Air leak: pneumomediastinum, pneumothorax, cystic lung disease, obstructive emphysema
  • Pulmonary hemorrhage
  • Complications of asphyxia:- encephalopathy, seizures, oliguria, coagulopathy and thrombocytopenia pneumothorax, air leak syndromes (pneumopericardium, pneumo-mediastinum) 
 Management
  • Management: IV fluids, ventilator support,oxygen,Antibiotics
  • Exam Question
  • Meconium stooling is seen in 90 percent of newborns within the first 24 hours, and most of the rest within 36 hours.
  • Patient with leakage of fluid and meconium stained liquor at 34 weeks of gestation is suffering from preterm premature rupture of membrane (PROM)
  • Meconium is excreted by a new born till 3 day
  • Saffron coloured meconium is seen in post maturity
  • Meconium aspiration syndrome occurs when infants take meconium into their lungs during or before delivery.
  • Meconium contains - i) Intestinal epithelial cells iii) Mucus v) Bile
  • ii) Lanugo iv) Amniotic fluid vi) Water
  • Meconium stained liquor (amniotic fluid) with respiratory distress soon after birth suggests the diagnosis of meconium aspiration syndrome
  • Complications: Persistent pulmonary hypertension
  • Obstructive emphysema can occur as a result of passage of meconium in utero
  • Chest X-ray: bilateral heterogeneous opacities (patchy infiltrates), coarse streaking of both lung fields, areas of hyper expansion, atelectasis and air leak, increased AP diameter, flattening of diaphragm
  • Management: IV fluids, ventilator support,oxygen,Antibiotics
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