Meconium Aspiration Syndrome

Signs and Symptoms

Passage of meconium before a baby is born can be triggered by different stresses to the fetus. Usually this stress results from normal labor contractions, but sometimes it is due to causes like infection, poor blood or low oxygen flow to the fetus. In fact, meconium can be seen in the amniotic fluid of about 12 percent of all deliveries.

Risk factors for meconium aspiration include:

• Post-term pregnancy
• Preeclampsia
• Maternal diabetes
• Maternal hypertension
• Difficult delivery
• Fetal distress
• Intra-uterine hypoxia, a condition in which a fetus receives a decreased amount of oxygen while still in the uterus

When meconium gets into a mother's amniotic fluid, it is called meconium staining. In these instances, the amniotic fluid may have a greenish color or streaks of green. Although each baby may experience symptoms of meconium aspiration differently. Exposure to meconium in the amniotic fluid for a long time may cause yellowed skin and nails. The following are the most common symptoms of meconium aspiration:

• Rapid or labored breathing
• Retractions, pulling in of the chest wall
• Grunting sounds with breathing
• Bluish skin color, called cyanosis
• Low Apgar score -- the Apgar test is given to infants just after birth to quickly evaluate their color, heartbeat, reflexes, muscle tone and respiration
• The body appearing limp

Diagnosis

The presence of meconium in a mother's amniotic fluid is key to diagnosing meconium aspiration. If meconium aspiration is suspected, your doctor may examine your baby's vocal cords for meconium staining through a procedure called a laryngoscope. The doctor also may listen to the baby's chest with a stethoscope to check for sounds of abnormal breathing. An X-ray of the baby's chest also may help to diagnose the condition.

Treatment

In instances where meconium aspiration does occur, specific treatments may depend on the amount and thickness of the meconium, length of time your baby was exposed to it and the severity of the respiratory problems your baby is experiencing.

If a mother's amniotic fluid appears to have meconium, a technique called amnioinfusion may be used during labor. This procedure inserts a small tube into the uterus through the vagina to infuse the amniotic fluid with sterile fluid, which may help to dilute the meconium.

Other treatments preformed at delivery may include:

• Suctioning of the baby's upper airways, including the nose, mouth and throat
• Supplemental oxygen given by hood or mechanical ventilator
• Chest physiotherapy, a technique of tapping on the baby's chest to loosen secretions
• Antibiotics to treat infection
• Radiant warmer to maintain your baby's body temperature