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Meconium Aspiration

Meconium aspiration syndrome is a rare disorder that occurs when a baby breathes in meconium (stool) during delivery. This condition occurs when a baby has a bowel movement in utero and then during delivery breathes amniotic fluid and meconium (stool) into their lungs. This can lead to poor lung function at delivery and even lead to death in the newborn period if severe.

Causes & Risk Factors

Healthcare workers are not completely sure what causes babies to have bowel movements in utero. It is thought that babies that undergo stress during the delivery process have a higher rate of passing stool and developing meconium aspiration syndrome. However, some healthcare workers believe that it may just be a natural event that occurs at the wrong time. There are known risk factors that seem to correlate with meconium aspiration syndrome. Most risk factors lead to stress in the baby, and these risk factors include:

  • Post dates pregnancy – When your pregnancy goes past 40 weeks, your placenta may start to age and calcify. This makes it more difficult for your baby to obtain the nutrients it needs to stay healthy.

Other risk factors include:

  • Maternal diabetes
  • Maternal hypertension
  • Long or difficult labor
  • Small for gestational age

Symptoms

If your baby develops meconium aspiration syndrome, it means that they have breathed in the amniotic fluid and meconium mixture. This leads to inflammation in your baby’s lungs and can lead to difficulty keeping their oxygen levels normal. Symptoms include:

  • Cyanosis or bluish skin
  • Difficulty breathing including rapid breathing, grunting while breathing, or labored breathing
  • No breathing at birth
  • Hypotonia

Reference Articles

Diagnosis

The diagnosis of meconium aspiration syndrome first starts with visualizing meconium in the amniotic fluid. When a woman’s water breaks, it should be clear and odorless. If it is meconium stained, then your baby will be at risk for meconium aspiration syndrome. Once your baby is delivered, if they have difficulty breathing, then meconium aspiration syndrome will be on the differential list for a diagnosis. Tests needed for diagnosis may include:

  • Chest x-ray
  • Blood gas test
  • Pulse ox for oxygen saturation

Meconium aspiration syndrome can be diagnosed clinically and may be diagnosed simply with respiratory distress and with the history of meconium-stained fluid. However, if a baby needs further support such as intubation, then chest x-ray and blood tests can be completed to further delineate the diagnosis.

Treatment

Meconium aspiration syndrome can be treated with supportive care. The syndrome is a spectrum, and some babies only need help with a thermal environment and oxygen, while others need intubation and mechanical ventilation. Once the inflammation in the lungs heal, then babies can be weaned to room air and taken off of their oxygen support.

Meconium aspiration syndrome is a rare but serious condition that usually results from stress to the baby during the labor and delivery process. It can be treated but can also lead to severe respiratory distress and even mechanical ventilation. The prognosis is great, and most babies heal their lungs within 2-4 days of developing the syndrome.

 
 
 

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