Meconium aspiration syndrome

It is a serious situation in the newborn and consists of the aspiration of a mixture of amniotic fluid and meconium into the lungs at the time of delivery. Meconium is the name given to the first stools (stools) of the newborn that are characteristically black and very sticky. It occurs in 5-10% of deliveries and is a potentially serious situation, it can cause serious sequelae or even death of the baby.

Causes and risk factors

The stress that the baby undergoes during labor can cause an increase in bowel movement and relaxation of the anal sphincter with the consequent expulsion of meconium within the uterus; in this way the meconium passes into the amniotic fluid. If the baby breathes while it is still in the womb or is still covered with meconium after birth, this fecal matter can enter the lungs and cause breathing problems.

Risk factors for meconium aspiration:

• Fetal suffering
• Complicated delivery
• Decreased oxygen reaching the baby while it is still in the womb (hypoxia)
• Mother with diabetes
• Mother with hypertension

Symptoms

The first warning sign of a possible meconium aspiration syndrome is that the amniotic fluid turns dark green. Amniotic fluid leaks out when the woman "breaks the water." When the baby is born, the skin is usually impregnated with meconium and there may even be meconium in the mouth and vocal cords.

Due to the respiratory problem, the newborn has a bluish color (cyanosis) because a sufficient amount of oxygen does not reach it. He cannot breathe properly, it takes a lot of effort for him to carry out the respiratory movements; You may even have a respiratory arrest (stop breathing). The Apgar test may be low.

Diagnosis

Right after birth, if the baby has not yet taken the first breath, the mouth and vocal cords should be checked for meconium and, if so, removed by aspiration before taking the first inspiration. In this way we will prevent the meconium from reaching the lungs. When the pediatrician auscultates the newborn he hears abnormal noises and the chest x-ray may show damaged areas of the lung.

Evolution and treatment

If there is suspicion that the baby makes a meconium aspiration, the airway must be aspirated to remove as much of this fecal material as possible and prevent it from reaching the lungs. The newborn is admitted and given antibiotics and breathing aid (oxygen or assisted ventilation depending on severity). In most cases the prognosis is very good and the baby recovers without problems.

In some cases, the baby may be severely affected and require assisted ventilation for several days. The sequelae depend on brain damage caused by lack of oxygen and lung involvement.

Prevention

During delivery, the fetus should be monitored to detect if it is suffering or unwell. When the doctor detects any sign of fetal distress, he can make an immediate intervention in the delivery room to avoid a meconium aspiration syndrome. In the event that the mother breaks water outside the hospital and these are brown or green, she should go immediately to the emergency room.