Meconium

 a sticky, tarlike, blackish green, odorless material formed from mucus, vernix, lanugo, hormones and carbohydrates that accumulated during intrauterine life.

Meconium Staining


occurs when meconium-stained amniotic fluid is aspirated into the lungs of an infant prior to, during, or immediately after birth.

Pathophysiology and Mechanism

 Due

to a combination of primary surfactant deficiency and surfactant inactivation as a result of plasma proteins leaking into the airways from areas of epithelial disruption and injury.

The leading three (3) causes of Meconium Staining are...

Due to physiologic maturation event, 2. A response to acute hypoxic events, and 3. A response to chronic intrauterine hypoxia.
1.

If an infant inhales this mixture before, during, or after birth, it may be sucked deep into the lungs. Three (3) main problems occur if this happens:
1. 2. 3.

The material may block the airways Efficiency of gas exchange in the lungs is lowered The meconium-tainted fluid is irritating, pneumonitis and possibly leading to chemical pnemonia.

Meconium staining of the amniotic fluid can be: LIGHT- there is a small amount of meconium diluted in a plentiful amount of amniotic fluid.  MODERATE- there is a fair amount of amniotic fluid, but it is clearly stained with meconium.  HEAVY- there is reduced amniotic fluid and a large amount of meconium, making the staining quite thick.


Sign and Symptoms

Before/During Labor:  Greenish or yellowish appearance of the amniotic fluid  Infants skin, umbilical cord or nailbeds may be stained green if the meconium was passed a considerable amount of time before birth

After: Rapid or labored breathing Cyanosis Slow heartbeat Barrel-shaped chest

Therapeutic Management
Suctioning w/ a bulb syringe or catheter  Amnioinfusion  Oxygen administaration  Assisted ventilation  Antibiotic therapy (ampicillin)  Surfactant administration  Maintain a temperature-neutral environment