Meconium Aspiration Syndrome In Newborn Infants
Newborn babies face many risks, especially during birth. One of the risks is meconium aspiration (MAS).
Causes children to breathe meconium
Meconium is the waste from the fetal digestive tract. It is dark green, thick, odorless and sterile. Meconium contains water (70-80%), squamous cells, secretions from the digestive tract, fetal hair, amniotic fluid, glycoproteins and bile salts.
Expulsion of prenatal meconium may be related to fetal stress in the womb such as infection, difficult labor, umbilical cord compression, etc., causing fetal hypoxia, stimulation of parasympathetic nerves increases intestinal activity, relaxes the anal sphincter and expels meconium into the amniotic fluid around the fetus.
Normal fetus also has a phenomenon of expelling meconium in the uterus or during childbirth, indicating maturation of the gastrointestinal tract
In the uterus, the amniotic fluid that goes in and out of the fetal trachea (upper part of the airways), when the fetus is in the uterus or at birth will breathe meconium into the lungs, the This breathing occurs when there is a hypoxia such as an infection or pinched umbilical cord…
Babies who breathe meconium may have respiratory failure and require mechanical ventilation after birth
Is aspiration of meconium dangerous?
MAS can occur before or after birth, as babies breathe amniotic fluid that contains meconium, partially or completely obstructing the airway, causing lung gas exchange disorders and severe respiratory failure.
The chemical irritation of meconium also causes pneumonia, infection and inactivation of surfactant (present on the surface of the alveoli, helping the alveoli expand and ventilation well).
The severity of MAS depends on the amount of meconium aspiration the child inhales, the more serious, as well as the underlying medical conditions such as fetal infection, congenital heart, malformation ...
Meconium aspiration is a possible complication at birth. About 8 - 15% of babies have meconium-stained amniotic fluid, most of them born term or old, very rare in premature babies. 5% of the amniotic fluid containing meconium has pneumonia caused by meconium aspiration and 50% of these require mechanical ventilation
Signs of neonatal meconium aspiration
Before and during birth, babies who breathe meconium will have the following symptoms:
There is meconium in the amniotic fluid or dark green stains
Your baby's skin is different, discolored, maybe blue, or green because the child is dyed with meconium
Babies have breathing problems such as rapid breathing, shortness of breath, stop breathing, bulging chest .
Before birth, your baby has an abnormally low heart rate
What to do when children breathe meconium
Babies who breathe meconium should be monitored closely during the first 24 hours after birth, even if they have good symptoms, as up to 20-30% of cases may develop later. When a child inhales the amniotic fluid containing meconium, it is necessary to suck up the amniotic fluid in the pharynx.
The days near the birth of a mother should have regular antenatal care to understand the situation of the baby
If the child has severe symptoms such as respiratory failure, weak movement, bradycardia less than 100 beats / minute ... then the doctor must perform meconium aspiration fluid through intubation to clean the upper and lower airways, help to clear the airway and then give the child oxygen.
After performing amniocentesis, the child should be monitored at a health facility:
Mechanical ventilation, oxygen if the child has severe respiratory failure
Give children antibiotics to fight infections
Respiratory physiotherapy makes it easier for the baby to breathe
Watch for complications such as pneumothorax, infection…
Prevent children from meconium aspiration
Babies who inhale amniotic fluid containing meconium are very dangerous, and can even be life threatening if not handled promptly. Therefore, prevention plays a very important role.
Pregnant women at risk of pre-eclampsia, hypertension, fetal growth retardation, chronic pulmonary heart disease ... should be closely monitored throughout pregnancy and at birth. At the close of delivery, if the ultrasound shows that the amniotic fluid is dark green, it is very likely that the baby will breathe meconium. At this time, the mother should immediately notify the doctor to monitor the fetal heart rate and take early interventions to avoid dangerous complications.
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