Definition
Meconium aspiration syndrome is a serious complication related to childbirth.
Meconium is the material present in the intestine of the fetus, and is normally eliminated spontaneously after birth. Sometimes, however, this black-greenish material is evacuated in the amniotic fluid, in response to the physiological stress that occurs during labor.
Therefore, near the birth, the child can aspirate meconium mixed with amniotic fluid. Possible consequences are mechanical obstruction of the airways, inflammatory pneumonia and respiratory distress.
Factors that favor meconium aspiration syndrome include maternal pre-eclampsia, post-term pregnancy (gestation greater than 40 weeks), difficult labor or prolonged labor, intra-intrauterine hypoxia caused by umbilical cord compression and placental insufficiency.
Most common symptoms and signs *
- Asthenia
- Pulmonary atelectasis
- bradycardia
- Cyanosis
- Dyspnoea
- Hypoxia
- pneumomediastinum
- pneumothorax
- Wheezing breath
- Ronchi
- tachypnoea
- Barrel chest
Further indications
Symptoms of meconium aspiration syndrome include wheezing, tachypnea, rales, ringing and cyanosis. Also indicative is the yellow-greenish meconium staining of the umbilical cord, the nail bed or the skin, sometimes visible also in the oropharynx, larynx and trachea.
At birth, the baby is given a low score of Apgar and appears weakened, with little muscle tone (hypotonia). Partial obstruction of the respiratory tract leads to air entrapment in the expiring lung, with possible barrel thorax, interstitial emphysema, pneumomediastinum and pneumothorax.
Diagnosis is suspected if traces of meconium are detected in the amniotic fluid. The baby's blood test reveals a low blood pH and oxygen desaturation. The diagnosis of meconium aspiration syndrome is confirmed by chest radiography. This demonstrates an exaggerated insufflation with areas of atelectasis. Furthermore, liquid can be observed in the pleural spaces and air in the soft tissues or in the mediastinum.
The treatment of meconium aspiration syndrome consists of an energetic aspiration of the mouth and the nasopharynx, immediately after birth and before the newborn breathes and cries, followed by respiratory support as needed. Complementary interventions may include the administration of surfactant (to improve lung function and reduce the possibility of lung failure) and antibiotics (to prevent infection).
