Meconium aspiration syndrome occurs when an infant breathes meconium (fecal matter produced before birth) into their lungs before or during delivery, often due to physiological stress in utero. This can lead to lung injury and respiratory distress through mechanisms like airway obstruction, surfactant inactivation, and chemical pneumonitis. Affected infants may experience symptoms like tachypnea, cyanosis, and retractions. Treatment involves vigorous suctioning at birth and supportive care like ventilation and antibiotics. Complications can include pulmonary issues, cardiac problems, and sepsis.

1. MECONIUM
ASPIRATION
SYNDROME

2. Meconium Aspiration
Syndrome.flv

3. Mecomium Aspiration.flv

4. Definition:
 is respiratory distress in a newborn
who has breathed (aspirated)
meconium into the lungs before or
around the time of birth.
 Meconium is the dark green fecal
material that is produced in the
intestines before birth

5. Etiology and Pathophysiology
 Physiologic stress at the time of labor
and delivery(e.g., from hypoxia
caused by umbilical cord compression
or placental insufficiency or from
infection) may cause the fetus to pass
meconium into the amniotic
fluid before delivery

6.  During delivery, perhaps 5% of infants
with meconium passage aspirate the
meconium, triggering lung injury
and respiratory distress, termed
meconium aspiration syndrome
 Post term infants delivered through
reduced amniotic fluid volume are at
risk of more severe disease.

7. The mechanisms by which aspiration induces the
clinical syndrome probably includes:
 nonspecific cytokine release.
 airway obstruction.
 surfactant inactivation.
 chemical pneumonitis
 Physiologic Stressors
-complete bronchial obstruction occurs, atelectasis
results
-partial blockage leads to air trapping on expiration,
resulting in hyper expansion of the lungs and
possibly pulmonary air leak

8.  Continuing hypoxia may lead to
persistent pulmonary hypertension of the
newborn Infants may also aspirate vernix
caseosa, amniotic fluid, or blood
of maternal or fetal origin during delivery
and can develop respiratory distress

9. SIGNS AND SYMPTOMS
 tachypnea
 nasal flaring
 retractions
 cyanosis
 desaturation
 greenish yellow staining of the umbilical cord
 pneumothorax
 pulmonary interstitial emphysema
 pneumomediastinum
 retractions

10. DIAGNOSIS
 Diagnosis is suspected when a neonate
demonstrates respiratory distress in the
setting of meconium-tinged amniotic fluid
and is confirmed by chest x-ray
demonstrating hyperinflation with
variable areas of atelectasis and
flattening of the diaphragm.
 Fluid may be seen in the lung fissures or
pleural spaces, and air may be seen in
the soft tissues or mediastinum

11. PROGNOSIS
 Prognosis is generally good, although
it varies with the underlying
physiologic stressors; over all mortality
is slightly increased. Infants with
meconium aspiration syndrome may
be at greater risk of asthma in later
life.

12. TREATMENT
 Immediate treatment, indicated for all
neonates delivered through meconium, is
vigorous suctioning of the mouth
and nasopharynx using a De Leesuction
apparatus as soon as the head is delivered
and before the neonate breathes and cries
 If the infant has labored or depressed
respirations, poor muscle tone, or is
bradycardic (< 100beats/min), the trachea
should be intubated with a3.5- or 4.0-mm
endotracheal tube

13.  physical examination and chest x-ray is
important to detect some complications
such as: pulmonary air-leak syndrome,
respiratory distress,
 infant whose BP, perfusion, or O2
saturation suddenly worsens
 surfactant for mechanically ventilated
infants with high O2 requirements.
 antibiotics (usually ampicillin and
gentamycin)

14. NURSING MANAGEMENT
 Observe for complications such as:
= pulmonary air leaks
= anoxic cerebral injury evidenced by
congestive heartfailure or cardiomegaly
= disseminated intravascular coagulation (DIC)
resulting,,from hypoxic hepatic damage
demonstrated by hematuria, oliguria,
or anuria
=fluid over load
=sepsis secondary to bacterial pneumonia