Meconium Aspiration

Syndrome
RISK FACTORS
Physiologic stress at the time of labor and
delivery (eg, due to hypoxia caused by
umbilical cord compression or placental
insufficiency or caused by infection) may cause
the fetus to pass meconium into the amniotic
fluid before delivery
 meconium passage is noted in about 10 to
15% of births. During delivery, perhaps 5% of
neonates with meconium passage aspirate the
meconium, triggering lung injury and
respiratory distress, termed meconium
aspiration syndrome.
Postterm infants delivered through reduced
amniotic fluid volume are at risk of more
severe disease because the less dilute
meconium is more likely to cause airway
obstruction.
Signs and symptoms
Tachypnea, nasal flaring, retractions, cyanosis or desaturation,
rales, rhonchi
Greenish yellow staining of the umbilical cord, nail beds or
skin.
Meconium staining maybe visible in the oropharynx, larynx
and trachea
Neonates with air trapping may have barrel chest
Chest x-ray result shows hyperinflation with variable areas of
atelectasis and flattening of diaphragm, fluid in the lung
fissures or pleural spaces & air maybe seen in the soft tissues
or mediastinum
Diagnostic test
Chest x-ray
Treatment

Suctioning at birth before the first breath

Endotracheal intubation (3.5-4mm) as needed- poor
muscle tone, depressed resp. , bradycardia
Mechanical ventilation as needed
Supplemental O2 as needed
IV antibiotics
SURFACTANT for mechanically ventilated neonates
NURSING CONSIDERATIONS
ENSURE THAT EQUIPMENT SUCH AS OXYGEN AND
SUCTION IS FUNCTIONING PROPERLY AND ASSISTS WITH
CARE AT DELIVERY.
ALTHOUGH MECONIUM IS STERILE, LUNG DAMAGE
PROMOTES THE GROWTH OF BACTERIA. CLOSE
MONITORING OF INFANT FOR INFECTION IS VERY
IMPORTANT TO PREVENT FURTHER COMPLICATION.