This usually happens while he is still in the womb but may happen during or shortly after birth. All structured data from the file and property namespaces is available under the creative commons cc0 license. If you continue browsing the site, you agree to the use of cookies on this website. Meconium plug syndrome msd manual professional edition. Pathophysiological and immunological aspects of meconium aspiration syndrome bodil salvesen department of pediatric research. Advances in the management of meconium aspiration syndrome article pdf available in international journal of pediatrics 201216879740. Symptoms and signs infants present in the first few days of life with failure to pass stools, abdominal distention, and vomiting. Universal intrapartum suction of infants with meconium stained amniotic fluid msaf and.
Meconium aspiration syndrome mas is a complex respiratory disease of the term and nearterm neonate. Destination page number search scope search text search scope search text. Meconium is the first intestinal discharge of the newborn epithelial cells, fetal hair, mucus, bile intrauterine stress. Pathophysiological and immunological aspects of meconium. Meconium plug syndrome and meconium ileus springerlink.
Meconium aspiration syndrome mas is defined as respiratory distress in a foal born through amniotic fluid stained with meconium in which the symptoms cannot be explained by other etiologies. Predictors of mortality in neonates with meconium aspiration. Files are available under licenses specified on their description page. Inhalation of meconium causes airway obstruction, atelectasis, epithelial injury, surfactant inhibition, and pulmonary hypertension, the chief clinical manifestations of which are hypoxaemia and poor lung compliance. Meconium aspiration syndrome mas develops when the baby aspirates breathes in meconium. The specific treatment for meconium aspiration syndrome depends on the amount of meconium inhaled, the length of time the infant was exposed to the same, and the severity of respiratory distress. Risk factors differentiating mildmoderate from severe meconium. The meconium plug syndrome usually follows abenign course and responds readilytoconservative treatment. Treatment may include suctioning the newborns mouth as soon as the head emerges during delivery, deep suctioning of the. Meconium aspiration syndrome mas is a common cause of severe respiratory.
Therefore, mas has a wide range of severity depending on what conditions and complications develop. Meconium plug syndrome definition of meconium plug. The deficiency of surfactant or surfactant dysfunction may contribute to respiratory failure in a broader group of disorders, including meconium aspiration syndrome mas. Pdf meconium staining of amniotic fluid occurs in 1015% deliveries and meconium aspiration syndrome occurs in 5% of those deliveries. The 2005 guidelines did not support this practice because routine intrapartum suctioning does not prevent or alter the course of meconium aspiration syndrome. Meconium aspiration syndrome mas is a lifethreatening disorder in newborn infants. Meconium aspiration syndrome mas is defined as respiratory distress in newborn infants born through meconiumstained amniotic fluid msaf whose symptoms cannot be otherwise explained. 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. Learn about meconium stools and how long it takes for a baby to progress to transitional stools, then regular stools, and what problems might occur.
Intestinal secretions, mucosal cells, and solid elements of swallowed amniotic fluid are the 3 major solid constituents of meconium. It describes the spectrum of disorders and pathophysiology of newborns born in meconiumstained amniotic fluid msaf and have meconium within their lungs. Thick, inspissated, rubbery meconium forms a cast of the colon, resulting in complete obstruction. Symptoms include failure to pass meconium within the first 24 to 48 hours after birth, abdominal distension, and vomiting if complete intestinal blockage occurs. Meconium aspiration syndrome mas, a common cause of respiratory failure in neonates, is associated with high mortality and morbidity. Surfactant replacement therapy has been proven beneficial in the prevention and treatment of neonatal respiratory distress syndrome rds. Meconium plug syndrome, meconium ileus, and meconium ileus equivalent are conditions of gastrointestinal tract obstruction by thickened contents which will not pass. Advances in the management of meconium aspiration syndrome.
The disease is diagnosed and treated by radiographic contrast enema, but hirschsprung disease and cystic fibrosis should be excluded. Meconium aspiration syndrome mas is a lifethreatening dis ease that affects some neonates born with meconium staining. Meconium aspiration syndrome nursing care management. Suctioning of the hypopharynx is not a riskfree procedure. Meconium plug syndrome must be differentiated from other diseases that cause a failure to pass meconium or abdominal distension in infants, including small. Unlike later feces, meconium is composed of materials ingested during the time the infant spends in the uterus. Meconium aspiration syndrome can cause health complications for your newborn if left untreated. Meconium causes chemical pneumonitis and surfactant inactivation. Meconiuminduced release of cytokines is mediated by the trl4md2. In meconium plug syndrome, the colon is completely blocked with thick meconium.
Treatments for meconium plug syndrome including drugs, prescription medications, alternative treatments, surgery, and lifestyle changes. Meconium aspiration syndrome what you need to know. Mortality in meconium aspiration syndrome in hospitalized babies table ii. Meconium aspiration syndrome mas also known as neonatal aspiration of meconium is a.
Delivery of a newborn with meconiumstained amniotic fluid acog. 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 ileus refers to a neonatal bowel obstruction of the distal ileum due to abnormally thick and impacted meconium. Little effective treatment is available, other than supportive measures including artifical respiration and, occasionally, the use of heart. Meconium aspiration syndrome mas is an important cause of morbidity and mortality among term newborns. A free powerpoint ppt presentation displayed as a flash slide show on id. 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. Meconium plug syndrome merck manuals professional edition. Meconium is the first intestinal discharge from newborns, a viscous, darkgreen substance composed of intestinal epithelial cells, lanugo, mucus, and intestinal secretions eg, bile. Meconium aspiration syndrome can be treated by aiding the infant with breathing immediately after birth. Meconium plug syndrome is also called functional immaturity of the colon. Failure of a fullterm newborn to pass meconium in the first 24 hours may signal intestinal obstruction.
The following roentgen findings were almost always present in the meconium plug syndrome. The first intestinal discharge from newborns is meconium, which is a viscous, darkgreen substance composed of intestinal epithelial cells, lanugo, mucus, and intestinal secretions eg, bile. Always discuss all decisions with the oncall neonatologist. Meconium aspiration syndrome mas is defined according to cleary and wiswell as. Management of meconium aspiration syndrome benjamin j stenson allan d jackson abstract meconium aspiration syndrome mas affects 0. Meconium is the earliest stool of a mammalian infant. Meconium, a dark green material, is a newborns first stool. It also is caused by amniotic fluid the fluid that surrounds the baby while in his or her mothers uterus. This can cause breathing difficulties due to swelling inflammation in the babys lungs after birth. The condition which most often mimics meconium plug syndrome isthat ofhirschsprungs disease. Total admitted survived died n% n % total 109 74 67. Epidemiology up to 1015% of live births after 34 weeks can present with m.
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. Clinical features and diagnosis of meconium aspiration syndrome. Prevention and management of meconium aspiration syndrome. Treatment may include suctioning the newborns mouth as soon as the head emerges during delivery, deep suctioning of the windpipe. Meconium aspiration syndrome genetic and rare diseases. You could have a plug of meconium distal to the vocal cords and this is the reason that intubation. If the meconium is inhaled into the lungs meconium aspiration syndrome or mas it has the potential to be dangerous of even fatal to newborns. Meconium is a newborns first feces, which is typically passed in the first few days after birth. Other factors, such as maternal ethnicity, result in a higher prevalence of meconium aspiration syndrome mas. Mortality in meconium aspiration syndrome in hospitalized. Enzymes, bile salts, and free fatty acids in meconium irritate the airways and parenchyma, causing a release of cytokines. Surfactant displacement by meconium free fatty acids. Meconium aspiration syndrome an overview sciencedirect.
Meconium is composed of amniotic fluid, mucus, lanugo the fine hair that covers the babys body, bile, and cells that have been shed from the skin and the intestinal tract. Timely passage of the first stool is a hallmark of the wellbeing of the newborn infant. Surfactant for meconium aspiration syndrome in term and. Pdf meconium aspiration syndrome and neonatal outcome. Pdf risk factors for meconium aspiration in meconium. Mas can present with varying degrees of severity from mild respiratory distress to. Meconium, unlike later feces, is viscous and sticky like tar, its color usually being a very dark olive green. These are often very sick neonates, in severe respiratory distress. Meconium itself is harmless and most babies can pass it while still in utero or during labour and have no problems. Textbook of neonatal resuscitation nrp, 7th ed page 1. Meconium plug syndrome is also associated with cystic fibrosis. One study noted that 16% of cases of meconium plug syndrome were associated with magnesium tocolysis and only 3% were associated with hirschsprung disease. The purpose of this study was to determine risk factors. Forty two babies with meconium aspiration syndrome managed in neonatal intensive care unit of a service hospital were analysed.
Meconium plug syndrome is a transient functional abnormality of the newborns digestive system which consists of the delayed passage of the meconium beyond 2448 hours, abdominal distension, vomiting, and dilatation of the left colon. Meconium aspiration syndrome mas is defined as respiratory distress. Thus, suggesting there is free passage of the intestinal contents into the amniotic fluid. Its dangerous when the baby inhales either of these substances into his or her lungs before, during, or after birth. Meconium plug syndrome was first reported by clatworthy in 1956, describing a syndrome of colonic obstruction because of inspissated meconium. Meconium staining can occur before, during, or immediately after parturition, and meconium passage in utero is thought to primarily occur in response to. Unlike in the meconium plug syndrome, the meconium is abnormal in consistency. Meconium plug syndrome merck manuals consumer version. Meconium aspiration syndrome mas is a disease of the newborn lung in which meconium, the fetal stool, is passed before birth and then is inhaled into the lung.
Meconium in the lungs can cause inflammation and infection. Ppt meconium aspiration syndrome powerpoint presentation. Meconium aspiration syndrome is caused by the babys first stool feces. 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. Meconium aspiration syndrome mas also known as neonatal aspiration of meconium is a medical condition affecting newborn infants. If the meconium is abnormally thick or tarlike, it can block the large intestine colon. Respiratory support in meconium aspiration syndrome.