Meconium Aspiration Flashcards
What is meconium?
The first stool of an infant
What does it mean by meconium aspiration?
When baby aspirates meconium into their lungs prior or during birth and this can cause resp distress
What does meconium aspiration do?
Respiratory distress
What are the risk factors for meconium aspiration?
Post term delivery 40wks+ !!
Prolonged labour
chorioamnionitis
PE, HTN, Smoking, IUGR
What is the most sig risk factor for meconium aspiration?
Post term delivery : 40 weeks +
What does meconium stained liquor during ROM or at birth indicate?
The baby passed meconium so there is a risk that the baby will aspirate + fetal distress
What signs and symptoms will be seen on the baby if there has been meconium passing + aspiration?
Green staining of skin, nail beds, umbilical cord
Signs of resp distress
Low APGAR score
Crackles on fetal lung ausculation
What are the signs of resp distress?
Increased RR
Grunting
Cyanosis
Noisy breathing
use of accessory muscles
Meconium stained liquour + resp distress?
Think meconium aspiration syndrome
What will be seen on CXR for meconium aspiration?
Overinflated lungs
patches of collapse/actelectasis
and consolidation / infiltration
How to manage meconium aspiration in a newborn
Gentle suctioning of mouth and nose to remove reside
Antibiotics - IV gentamicin + Ampicillin
Transfer to NICU + oxygen
What antibiotics are given for meconium aspiration?
IV gentamicin and ampicillin
What if the resp distress from meconium aspiration is fevery severe?
Artificial ventilation
What is meconium ileus?
Thick, sticky infant with meconium that has prolonged passing time - so blocked the intestine
What is normal passing time for meconium?
24 hours of delivery
Can the baby vomit meconium?
Yes
What disease is meconium ileus associated with?
Cystic fibrosis 90%
Biliary atresia
How to manage meconium ileus
1st line - gastrograffin enema :
N-acetylcysteine
2nd line - Surgery
