Meconium Aspiration Syndrome

DEFINITION

Meconium Aspiration Syndrome occurs when the fetus is inhaling meconium mixed with amniotic fluid, either when the baby is still in the womb or shortly after birth.

Meconium is the first feces fetus removed. Meconium is the material that is thick, sticky and greenish-black.

In premature infants who have less amniotic fluid, meconium aspiration syndrome, which occurs very heavy. The inhaled meconium is more viscous so that more severe airway obstruction.

CAUSE

Meconium aspiration occurs when the fetus is stressed during labor progress. Infants may experience a lack of oxygen and makes meconium out into the amniotic fluid in the womb. If the fetus breathes while still in the womb or if the baby immediately breathe the first time of birth, it is a mixture of amniotic fluid and meconium can be inhaled into the lungs.

The inhaled meconium can cause a blockage of the airway, resulting in disruption of breath and impaired gas exchange in the lungs. In addition, the meconium can cause irritation and inflammation of the airways. Meconium aspiration is a major cause of severe illness and death in newborns.

Risk factors for meconium aspiration syndrome:

·         Pregnancy post-mature

·         Pre-eclampsia

·         Mother suffering from diabetes

·         Mother suffering from hypertension

·         Difficult labor

·         Fetal distress

·         Lack of oxygen when the baby is still in the womb

SYMPTOMS

Symptoms of meconium aspiration syndrome:

·         The amniotic fluid is greenish or apparent presence of meconium

·         Baby's skin looked greenish (if meconium has long been out before delivery)

·         Baby looks limp at birth

·         The baby's skin looks blue

·         Rapid respiratory rate and can occur stopping breathing (apnea)

·         Visible signs of post-maturity, such as birth weight less and flakiness

DIAGNOSIS

Diagnosis is based on symptoms exist and examination results, such as:

·         The existence of a slow heart rate before the baby is born

·         Amniotic fluid containing meconium

·         Low Apgar score

·         The presence of abnormal breath sounds (crackles)

In addition, the examination can be done such as blood gas analysis and chest X-rays.

TREATMENT

As soon as the baby's head is born, be suctioned fluid from the baby's mouth. If thick meconium and fetal distress, it could put a tube into the airway (trachea) and the baby be suctioned. This procedure is repeated until the baby inside the respiratory tract is no longer contained meconium.

If there are signs of fetal distress and baby appear to be active, but the skin is greenish, then some experts recommend not to perform tracheal suctioning too deep for fear of causing aspiration pneumonia.

After the baby is closely monitored. Another treatment that can be done include:

- Physiotherapy

- Giving oxygen to maintain oxygen levels in the blood

- Treatment to treat infections

- Keeping the baby's body temperature to keep warm

- Mechanical ventilation

COMPLICATIONS

Aspiration pneumonia

Pneumothorax

Brain damage from lack of oxygen

Respiratory disorders that persist for several days

REFERENCE

- G, Jay S. Meconium Aspiration. Kids Health. 2011.

- K, Arthur E. Meconium Aspiration Syndrome. Merck Manual Handbook. 2009.

- L, Kimberly G. Meconium Aspiration Syndrome. Medline Plus. 2011.