Abstract
Infants born through meconium-stained amniotic fluid (MSAF) are 100 times more likely than infants born through clear amniotic fluid to develop respiratory distress in the neonatal period. Meconium aspiration syndrome (MAS) is a common cause of respiratory distress in term and post-mature neonates. MAS is defined as respiratory distress accompanied by a supplemental oxygen requirement in an infant born with MSAF, in the absence of any other identified etiology to explain the symptoms. Therapy for MAS is supportive, and should be tailored to each infant’s specific pathophysiology. In cases of MAS with severe persistent pulmonary hypertension of the newborn (PPHN), patients may remain hypoxic despite aggressive ventilation, and in these cases surfactant, inhaled nitric oxide (iNO) and extracorporeal membrane oxygenation (ECMO) can be life-saving. Long-term prognosis for MAS is more related to severity of initial hypoxemia and possible neurological insult than to the pulmonary pathology.
Highlights
IntroductionMeconium aspiration syndrome (MAS) is a common cause of neonatal respiratory distress in term and post-mature neonates
Meconium aspiration syndrome (MAS) is a common cause of neonatal respiratory distress in term and post-mature neonates.Meconium is the stool that forms in the developing intestines throughout fetal life
Infants born through meconium-stained amniotic fluid (MSAF) are 100 times more likely than infants born through clear amniotic fluid to develop respiratory distress in the neonatal period, even in the absence of antenatal fetal heart rate abnormalities or the need for neonatal resuscitation [1,4,5,6]
Summary
Meconium aspiration syndrome (MAS) is a common cause of neonatal respiratory distress in term and post-mature neonates. Meconium is the stool that forms in the developing intestines throughout fetal life. Meconium staining of amniotic fluid occurs in approximately 10–13% of normal pregnancies, and approximately 4% of these infants subsequently develop respiratory distress [1,3]. Infants born through meconium-stained amniotic fluid (MSAF) are 100 times more likely than infants born through clear amniotic fluid to develop respiratory distress in the neonatal period, even in the absence of antenatal fetal heart rate abnormalities or the need for neonatal resuscitation [1,4,5,6]. When meconium staining of amniotic fluid is accompanied by a non-reassuring fetal heartrate tracing, there is a much greater likelihood of associated neonatal hypoxia, and associated morbidity. If fetal heartrate tracing remains normal, and meconium passage is not accompanied by acidosis, outcomes are generally favorable [1]
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