Meconium Aspiration Syndrome

Meconium aspiration syndrome is respiratory disease caused by aspiration of meconium stained amniotic fluid before or during birth. Meconium causes airway obstruction, chemical pneumonitis, surfactant dysfunction and pulmonary hypertension.

• Meconium staining
• Respiratory distress immediately after birth
• Tachypnoea
• Grunting
• Cyanosis
• Coarse crackles
• Hyperinflated chest

Severe disease may cause persistent pulmonary hypertension, air leak and profound hypoxaemia.

Chest radiograph may show patchy bilateral infiltrates, hyperinflation and areas of atelectasis.

Assess blood gas and oxygenation.

• Do not routinely suction the trachea solely because meconium is present.

• Prioritize effective ventilation when the newborn is apnoeic or bradycardic.

• Provide oxygen, CPAP or mechanical ventilation according to severity.

• Surfactant may be considered in severe disease.

• Persistent pulmonary hypertension may require inhaled nitric oxide where available.

• Treat pneumothorax immediately when clinically significant.