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Meconium Aspiration Syndrome
Aka: Meconium Aspiration Syndrome, Meconium Aspiration
- Epidemiology
- Prevalence
- Occurs in up to 15% of cases in which amniotic fluid is meconium-stained
- Occurs in as many as 1-2% of all deliveries
- Pathophysiology
- Meconium contains gastrointestinal fluids which cause localized inflammation
- Meconium Aspiration results in severe airway inflammation and Pneumonia risk
- Meconium Aspiration occurs in utero, not at delivery
- Signs
- Hypoxia
- Differential Diagnosis
- See Newborn Respiratory Distress
- Imaging: Chest XRay
- Patchy Atelectasis
- Lung consolidation changes
- Management: Meconium stained infant
- See Respiratory Distress in the Newborn
- See Newborn Resuscitation
- Infant brought to warmer with head angled down and with minimal stimulation
- Evaluate infant for vigorous activity
- Vigorous infants without distress may be managed routinely
- Infants with Heart Rate <100 beats/min, apnea, or poor tone require intervention
- Intubation
- Suctioning
- Prevention
- Suctioning head at the perineum no longer recommended
- See pathophysiology above regarding in utero aspiration
- Vain (2004) Lancet 364:597-602
- Amnioinfusion does not decrease Meconium Aspiration risk
- Fraser (2005) N Engl J Med 353:909-17