meconium aspiration syndorme

Question 1

what is meconium

what colour is it and it is passed after delivery

Answer 1

Meconium is the first faeces passed by a newborn, in contrast to later faeces it is usually very thick and dark green in colour. It is usually passed after delivery.

Question 2

Sometimes it may be expelled prior to birth into the amniotic fluid, which is known as

Answer 2

meconium stained liquor

Question 3

It is important that meconium is recognised as it may be a sign of foetal distress and hypoxia (which causes intestinal relaxation and anal sphincter relaxation).

It may be a non-pathological finding in prolonged pregnancies beyond 40 weeks gestation.

what can it lead too

Answer 3

meconium aspiration syndrome - passage of meconium from amniotic fluid into foetal lungs blocking airways

Question 4

what is meconium ileus

early sign of what disease

Answer 4

thcikned and obstruts the bowel - early sign of CF

Question 5

meconium ileus presentation

Answer 5

Meconium ileus usually presents as bilious vomiting, a distended abdomen and failure to pass meconium within the first 12 – 24 hours of life.

eave to bowel perforation, peritonitis , mal-rotation of the bowel and intestinal atresia.

Question 6

features of MAS

Answer 6

Presence of meconium stained liquor during rupture of membranes or at birth (greenish or yellowish appearance of the amniotic fluid)

Green staining of the infant’s skin, nail beds or umbilical cord

Signs of respiratory distress in the newborn (increased respiratory rate, grunting, cyanosis, noisy breathing, use of accessory muscles)

Limp infant or low APGAR score

Crackles on auscultation of the foetal lungs

Question 7

risk factors for MAS

Answer 7

Postdates pregnancy (>40 weeks gestation)
Prolonged or difficult labour
Chorioamnionitis
Problems during pregnancy such as pre-eclampsia, hypertension, oligohydramnios, maternal infection, placental insufficiency, intrauterine growth restriction

Question 8

management of MAS

Answer 8

If meconium aspiration syndrome is recognised, gentle suctioning of the mouth and nose should be carried out to remove any visible residual meconium.

Antibiotics should be given to reduce risk of infection and the baby should be transferred to a Neonatal Intensive Care Unit for oxygen administration and careful monitoring.

In severe cases of meconium aspiration syndrome, artificial ventilation may be required.