Meconium is the first intestinal discharge from newborns, a viscous, darkgreen substance composed of intestinal epithelial cells, lanugo, mucus, and intestinal secretions eg, bile. Advances in the management of meconium aspiration syndrome. Meconium stained amniotic fluid and meconium aspiration syndrome incidence consequences diagnosis treatment key points references incidence meconium can be found in the gastrointestinal tracts of fetuses as early as 1416 weeks gestational age. Mas can present with varying degrees of severity from mild respiratory distress to. Meconium aspiration syndrome johns hopkins medicine. Jan 12, 2012 meconium aspiration syndrome is a serious condition in which a newborn breathes a mixture of meconium and amniotic fluid into the lungs around the time of delivery. The aspirated meconium can completely block the newborns airways. Aspiration of meconium produces a syndrome characterized by hypoxia, hypercapnia, and acidosis. Mas can present with varying degrees of severity from mild respiratory distress to lifethreatening respiratory failure. Because meconium is rarely found in the amniotic fluid prior to 34 weeks gestation, mas is often a disease of the term and nearterm infant and is. Aspiration of meconium into the lungs results in a condition termed as meconium aspiration syndrome mas leading to obstruction of the airways by meconium, loss of surfactant and chemical pneumonitis. From fanaroff and martins neonatal perinatal medicine, diseases of the fetus and infant 8th edition, edited by r martin, a fanaroff and m walsh.
Berglund, influence of state of inflation of the lung on pulmonary vascular resistance j. Mar 14, 2018 this is known as meconium aspiration or meconium aspiration syndrome mas. Meconium aspiration syndrome mas is a common cause of severe respiratory distress in term infants, with an associated highly variable morbidity and mortality. The role of aspiration of meconium in producing respiratory disease in newborns, and its treatment, remain controversial. The possibility of inhaling meconium occurs in about 510% of births.
Start studying masmeconium aspiration syndrome learn vocabulary, terms, and more with flashcards, games, and other study tools. Meconium aspiration syndrome symptoms, diagnosis and. Sep 01, 2010 aspiration of meconium produces a syndrome characterized by hypoxia, hypercapnia, and acidosis. Nondelivery room management of meconium aspiration. Meconium aspiration syndrome moderator dr binod presenter int lalit karki 2. Wesenberg, meconium aspiration syndrome the newborn chest 1973 harper and row new york 11960. Meconium aspiration is also known as meconium aspiration syndrome. Its dangerous when the baby inhales either of these substances into his or her lungs before, during, or after birth. Although mas is often not lifethreatening, it can cause significant health complications for your newborn. The presence of meconium in amniotic fluid is required to cause meconium aspiration syndrome mas, but not all neonates with meconiumstained fluid develop this condition.
Introduction mas in the newborn is characterized by hypoxia, hypercapnia, and acidosis. Meconium aspiration syndrome is a serious condition in which a newborn breathes a mixture of meconium and amniotic fluid into the lungs around the time of delivery. Meconium stained amniotic fluid and meconium aspiration. Meconium aspiration syndrome etiology bmj best practice. Infants born through meconium stained amniotic fluid are at risk of developing meconium aspiration syndrome, particularly in the presence of maternal and fetal risk factors. Meconium aspiration syndrome nursing care management. Fetal hypoxic stress can stimulate colonic activity, resulting in the passage of meconium and also stimulates fetal gasping movements that result in meconium aspiration inutero. Mar 14, 2020 historically, approximately 10% of newborns born through meconium stained amniotic fluid developed meconium aspiration syndrome mas. Meconium aspiration syndrome an overview sciencedirect. It describes the spectrum of disorders and pathophysiology of newborns born in meconiumstained amniotic fluid msaf and have meconium within their lungs. Clinical practice guideline guideline coverage includes.
Meconium aspiration syndrome occurs in approximately 2% of these deliveries 1. Although it doesnt have any bacteria or odor, meconium can cause problems if a baby passes it while still in the uterus, where it will mix with amniotic fluid, and inhales aspirates the mixture before, during, or. This can cause breathing difficulties due to swelling inflammation in the babys lungs after birth. Meconium aspiration syndrome mas is defined as respiratory distress in newborn infants born through meconiumstained amniotic fluid msaf whose symptoms cannot be otherwise explained. Definition meconium aspiration syndrome mas is a respiratory distress of an infant born through meconium stained amniotic. This follows the aspiration of meconium stained amniotic fluid msaf, which can happen either antenatally 2. Meconium aspiration syndrome mas is a common respiratory disorder in term and nearterm neonates. Meconium aspiration syndrome mas is a consequence of aspiration of meconium occurring before, during, or immediately after delivery and is one of the most common causes of respiratory failure in infants born at term or after term. Mas is a clinical diagnosis that includes delivery through meconium stained amniotic fluid msaf with respiratory distress, characteristic. Pathophysiology and prevention of meconium aspiration syndrome. Meconium aspiration syndrome genetic and rare diseases.
Defined as respiratory distress in the newborn due to the presence of meconium in the trachea. Meconium aspiration syndrome mas is defined according to cleary and wiswell as respiratory distress in an infant born through meconiumstained amniotic fluid msaf whose symptoms cannot otherwise be explained 1. Meconium aspiration syndrome mas also known as neonatal aspiration of meconium is a medical condition affecting newborn infants. Meconium aspiration syndrome mas is the aspiration of stained amniotic fluid, which can occur before, during, or immediately after birth. Pdf advances in the management of meconium aspiration.
Meconium aspiration syndrome is caused by the babys first stool feces. Meconium stained amniotic fluid and meconium aspiration syndrome. Jul 24, 2019 meconium aspiration syndrome is caused by the babys first stool feces. A new look at the pathogenesis of the meconium aspiration. Release of meconium into the amniotic fluid is usually the result of in utero hypoxia andor fetal distress. The common denominator in the pathophysiology could therefore be activation of innate immunity. Clinical practice guideline guideline coverage includes nicu. The meconium aspiration syndrome mas is often preventable, yet cases of mas continue to occur. Meconium can make it harder to breathe because it can.
Meconium aspiration syndrome is a leading cause of severe illness and death in a newborn. Meconium aspiration syndrome childrens health issues. Meconium aspiration occurs secondary to intrapartum or intrauterine aspiration of meconium, usually in the setting of fetal distress, often in term or postterm infants. Meconium aspiration syndrome mas is defined as respiratory distress in newborn infants born through meconium stained amniotic fluid msaf whose symptoms cannot be otherwise explained. Mar 20, 2017 meconium aspiration syndrome mas is the aspiration of stained amniotic fluid, which can occur before, during, or immediately after birth.
Meconium is the first feces, or stool, of the newborn. Meconium aspiration syndrome mas happens when a newborn has trouble breathing because meconium got into the lungs. Perinatal hypoxia, acute airway obstruction, pulmonary inflammation, pulmonary vasoconstriction, pulmonary hypertension, and surfactant inactivation all play a role in the pathogenesis of meconium aspiration syndrome mas. Meconium aspiration syndrome occurs when stress such as infection or low oxygen levels causes the fetus to take forceful gasps, so that the amniotic fluid containing meconium is breathed aspirated in and deposited into the lungs. Infants with mas may be extremely ill and need extensive support. Meconium aspiration syndrome mas is a serious, lifethreatening condition that occurs in around 2% to 5% of all births. Meconium aspiration syndrome clinical presentation. Pediatric respiratory medicine second edition, 2008.
Meconium aspiration syndrome meconium is a newborns first feces, which is typically passed in the first few days after birth. After delivery, the aspirated meconium may block the newborns airways and cause regions of the lungs to collapse. A randomized, controlled study was performed to determine whether highdose surfactant therapy improves the pulmonary morbidity of term infants ventilated for. The pathophysiology of meconium aspiration syndrome mas is related not only to mechanical obstruction of the airways and chemical injury to the respiratory epithelium but also to surfactant inactivation by meconium. Meconium aspiration syndrome mas is a persistent problem in neonatal medicine. Mas can be diagnosed in any infant born with meconium staining of amniotic fluid who develops respiratory distress at or shortly after birth and. Despite a relatively low incidence, it is responsible for as many as.
Introduction meconium aspiration syndrome mas is defined as respiratory distress in newborn infants born through meconiumstained. Explain the pathophysiology that occurs after meconium aspiration. Meconium aspiration syndrome mas is a result of ante or postpartum aspiration of meconiumstained amniotic fluid in term or nearterm infants resulting in respiratory morbidity of varying severity. Although the mortality rates of infants with mas have vastly improved over the past few decades, infants are still at a heightened risk of lifelong medical complications, especially if medical treatment doesnt start. Clinical features and diagnosis of meconium aspiration syndrome.
Meconium aspiration syndrome mas page 2 of 4 neonatal guideline meconium is a potent activator of inflammatory mediators, including cytokines, complement, prostaglandins and reactive oxygen species. As meconium is rarely found in the amniotic fluid prior to 34 weeks of gestation, meconium aspiration usually affects babies born at term and postterm. Fetal hypoxic stress can stimulate colonic activity, resulting in the passage of meconium and also stimulates fetal gasping movements that result in. Jan 02, 2015 meconium stained amniotic fluid may be aspirated before or during labour and delivery. Intrauterine aspiration under stressful situations the baby ups the respiratory effort and gasps to help compensate bringing in amniotic fluid in the womb. Meconium aspiration syndrome mas is defined as respiratory distress in an infant born through meconium stained amniotic fluid msaf with characteristic radiological changes and whose symptoms cannot be otherwise explained. In regard to causing respiratory disease, about 35% of infants born in the presence of thick meconium have meconium present below their vocal cords.
Signs of meconium aspiration syndrome include tachypnea, nasal flaring, retractions, cyanosis or desaturation, rales, rhonchi, and greenish yellow staining of the umbilical cord, nail beds, or skin. Aspiration of meconium by the fetus at or near delivery may be associated with high infant morbidity and mortality. Meconium aspiration syndrome mas is an important cause of morbidity and mortality among term newborns. Meconium aspiration syndrome occurs when a newborn breathes a mixture of meconium and amniotic fluid into the lungs around the time of delivery. Databases from medline, md consult, and the science citation index were searched from 1964 to the present to find relevant sources of information. It may further lead to chemical irritation in the lung tissue, airway obstruction, and inactivation of surfactant.
Meconium aspiration syndrome usually affects babies born at term or postterm 3742 weeks gestation. Meconium aspiration syndrome definition of meconium. It occurs exclusively in the immediate neonatal period. Meconium aspiration syndrome epidemiology bmj best practice. Meconium aspiration syndrome, a leading cause of severe illness and death in the newborn, occurs in about 5 percent to 10 percent of births. Of the babies who suffer persistent pulmonary hypertension of the newborn. Severe mas is classified as cases that need mechanical ventilation. Meconium aspiration syndrome mas is defined as respiratory distress in the newborn due to the presence of meconium in the trachea. Meconium aspiration syndrome pediatrics msd manual. Meconium aspiration syndrome mas, a common cause of respiratory failure in neonates, is associated with high mortality and morbidity. Pathophysiology of meconium aspiration free download as word doc. Care of the infant with the meconium aspiration syndrome. Mas is essentially a clinical diagnosis and should always be suspected in a child with respiratory distress and meconiumstained amniotic fluid at.
Mas occurs in about 5% of deliveries with meconiumstained amniotic fluid12 and is one of the most common causes of neonatal respiratory distress. Meconium aspiration syndrome mas is a result of ante or postpartum aspiration of meconium stained amniotic fluid in term or nearterm infants resulting in respiratory morbidity of varying severity. From fanaroff and martins neonatal perinatal medicine, diseases of the fetus and infant 8th edition, edited by r. Epidemiology up to 1015% of live births after 34 weeks can present with m. Meconium aspiration syndrome treatment treatments for meconium aspiration depend on the amount and thickness of the meconium, length of time your baby was exposed to it and the severity of the respiratory problems your baby is experiencing. The severity of mas will depend on how much meconium the baby has inhaled. This is known as meconium aspiration or meconium aspiration syndrome mas. Infants born through meconiumstained amniotic fluid are at risk of developing meconium aspiration syndrome, particularly in the presence of maternal and fetal risk factors.
Pdf advances in the management of meconium aspiration syndrome. Meconium aspiration syndrome mas for parents nemours. Meconium aspiration syndrome mas is defined as respiratory distress in newborn infants born through meconium stained amniotic fluid msaf whose symptoms cannot be otherwise explained 1. Pathophysiology of meconium aspiration fetus medical. Surfactant replacement therapy for meconium aspiration. Meconium can affect the lungs in the following ways it can be an irritation to the lung tissue.
Despite the common occurrence of intrauterine meconium passage and resultant meconium aspiration syndrome mas, controversies regarding the pathophysiology and use of appropriate preventive strategies abound. Meconium staining may be visible in the oropharynx and on intubation in the larynx and trachea. It typically occurs when the fetus is stressed during labor, especially when the infant is past its due date. Mas results from aspiration of meconium during intrauterine gasping or during the first few breaths. Meconium is a thick, green viscous substance composed of epithelial cells, vernix, lanugo, mucus, amniotic fluid, intestinal secretions, etc. Meconium aspiration and its treatment health hearty. However, changes in obstetric and neonatal practices appear to be decreasing its incidence.
As a result, heshe may find it difficult to breathe. The diagnosis of mas requires the presence of meconiumstained amniotic fluid or neonatal respiratory distress, as well as characteristic radiographic abnormalities. It also is caused by amniotic fluid the fluid that surrounds the baby while in his or her mothers uterus. If meconium is passed more than 4 hours before delivery, the infants skin will be meconium stained. Meconium aspiration syndrome mas is defined as respiratory distress in newborn infants born through meconiumstained amniotic fluid msaf whose symptoms cannot be otherwise explained 1. Meconium aspiration syndrome an overview sciencedirect topics. Meconium aspiration syndrome mas is the term used to describe a spectrum of disorders, marked by various degrees of respiratory distress in the new born infant.
607 6 892 27 987 491 801 480 640 27 871 1448 1384 472 345 204 630 366 589 223 620 902 1409 756 514 366 1097 84 1156 1386 792 401 787 145 176 623 107 1083 679