Meconium stained amniotic fluid with meconium aspiration syndrome by uma
1. CASE PRESENTATION ON
MECONIUM STAINED
AMNIOTIC FLUID WITH
MECONIUM ASPIRATION
SYNDROME
Presented by
T.Uma Devi
4th Pharm-D
(611171602024)
2. PATIENT PROFILE FORM
• Patient’s mother name:- Nagamani
• Age:-1day
• Weight:-3kgs
• Unit:-NICUI
• Gender:-Male
• IP no:-65360
3. REASONS FOR ADMISSION
• Yellowish colour of skin and nails, respiratory disstress,
tachypnea. postive bilatéral air entry.
Past medical history:-
• Not significant.
Past medication history:-
Not significant.
Family history:-
As the patient new born ,so their is no history.
5. PHARMACEUTICAL CARE
PLAN
Subjective Evidence:-
Yellowish colour of skin and nails, respiratory disstress,
tachypnea, positive bilatéral air entry.
Objective Evidence:-
Chest X-ray, Stethoscope, Blood gas test.
Assessment:-
Based on subjective and objective evidences the
diagnosis was made as Meconium stained amniotic
fluid with meconium aspiration syndrome.
6. GOALS TO BE ACHIEVED
• To reduce respiratory dystress.
• To increase oxygen supply to new born.
• To reduce the intestinal infection caused by
meconium.
• To reduce the meconium levels in the boby.
7. TREATMENT OPTIONS
1. Antibiotics:- Ampicilline , gentamicine
2. Warmth care by
• Mother
• Radiant warmer
• Ventilator
3. Oxygen therapy by
• Masks
• hoods
4. Amnio infusion
5. Extra corporeal membrane
8. MECONIUM STAINED
AMNIOTIC FLUID (MSAF)
• Greenish or yellowish appearence of the amniotic
fluid. Infants skin, umblical cord , nail beds may be
stained green if the meconium was passed a
considerable amount of time before birth. Inhaled in
the fluid by gasping in utero or after birth.
9. MECONIUM ASPIRATION
SYNDROME (MAS)
• Meconium is dark –green faecal material that was
produced in the intestine of a foetus before birth.
After delivery new born expels meconium stools for
the first few days of life. Stress baby experiences
before or during birth may cause expulsion of
meconium into the amniotic fluid.
• If méconium is present in the amniotic fluid, this is
known as meconium aspiration syndrome.
11. Close up of left lung demonstrating the streaky lucencies of the air in
the interstitium (red arrows) complicated by a pneumothorax
(yellow arrow).
12. DRUG CHART
Sno Drugs list Dose Route Frequency D1 D2 D3 D4 D5
1 Warmth care - - - X X X X
2 Oxygen
inhalation with
hood
5liters Nasal - X X X X
3 IVF-
10%Dextrose
180ml IV 1-0-0 X X X
4 Inj.Ampiclox 150mg IV 1-0-1
5 Inj.Amikacin 45mg IV 1-0-0
6 Inj.Vitamin-K 8 μgm IM 1-0-0 (first
24 hours)
X X X X
18. INVESTIGATIONS
• Blood gas analysis:-Low blood PH ,increased CO2 and
decreased O2.
• Chest X-ray:-Patchy infiltrates, coarse streaking of both lungs
and flattening of the diaphragm.
• CRT:- <2sec
• Stethoscope:- Abnormal lung sounds are heard.
• Cry:- Good General condition:-Alert
• Single , terminal
• Normal vaginal delivery
• Accurate gestation age
19. GOALS ACHIEVED
• Respiratory disstress was decreased by day-3.
• Complete meconium was removed from the
body by day-2.
• Intestinal infections are reduced.
• Oxygen is sufficient supplying to the baby.
• Rooting and sucking is good by day-3.
20. MONITORING PARAMETERS
• Blood gas test is to confirm lung function by
calculating O2 intake.
• Chest X-ray is for to see patchy or streaked
areas on the lungs.
• Listen to the grunt sounds regularly from time
to time
21. PATIENT COUNSELLING
• About disease:-
Mother should take care of the new
born.Mother warm care is
important. Oxygen supply should
be increased for new borns.
22. About drugs:-
• IVF-Dextrose:-
As the patient is not on feeding. So
nutrients required for the body is supplied by
this dextrose .
• Ampiclox:-Ampicillin+Cloxacillin
As meconium is injected by the baby.It is
very infectious as it contains fecal material.So
to decrease those infections this antibiotic is
used twice a day.
