Meconium Aspiration Syndrome

Question 1

What is the pathophysiology of meconium aspiration?

Answer 1

Term/near term infants when meconium is passed in utero, meconium stained amniotic fluid, infant then inhales meconium.

Question 2

What is the cause of meconium aspiration?

Answer 2

Hypoxia in utero causes meconium to pass early.

Question 3

What is this a presentation of?
Hypoxia of newborn, respiratory distress, over-inflation/collapse/consolidation in lungs, pneumothorax, surfactant dysfunction, persistent pulmonary hypertension of the newborn.

Answer 3

Meconium aspiration syndrome

Question 4

How is meconium aspiration syndrome investigated?

Answer 4

Chest x-ray:

1. Hyperinflated with areas of collapse/consolidation
2. Patchy appearance/cystic appearance

Question 5

What is the management for meconium aspiration syndrome?

Answer 5

1. Suctioning only if baby not vigorous at birth.
2. Mechanical ventilation, surfactant.
3. Inhaled nitrous oxide in persistent pulmonary hypertension of the newborn.