Meconium aspiration syndrome

Question 1

RF for MAS

Answer 1

IU hypoxia
Postmaturity >42w
Maternal hx of HTN/PET/smoking/substance abuse
Oligohydramnios
Chorioaminitis

Question 2

Symptoms / signs

Answer 2

AT BIRTH

Limp baby
Low agpar score
Rapid, laboured or absent breathing
Postmaturity signs
Foetal bradycardia
Overinflated lungs with patches of consolidation and collapse

Question 3

Diagnostic inx

Answer 3

CXR

Question 4

Mx

Answer 4

Spontaneous breathing - no resus needed

Resp not established, -> lung inflation

If born through thick meconium - inspect oropharynx and suction with large bore catheter

Consider antibiotics

Question 5

What do you do if the baby becomes bradycardic?

Answer 5

If bradycardic - positive pressure ventilation to aerate lungs DESPITE meconium

Question 6

What antibiotics would you give

Answer 6

IV ampiciillin and gentamicin

Question 7

Complications of MAS

Answer 7

Pneumothorax
Pneumomediastinum
PPHN

Question 8

Prognosis

Answer 8

Death
Neuro difficulties if IU hypoxia
Reactive airway disease in the long term

Question 9

What do you call it when a baby doesn’t pass meconium?

Answer 9

Meconium ileus

Question 10

What is the normal time for a baby passing poo?

Answer 10

Within 24hr of delivery

Question 11

Mx of Mec ileus

Answer 11

Gastrograffin enema

or surgery

Question 12

Differentials for mec ileus cause

Answer 12

CF
Biliary atresia