meconium stained amniotic fluid when infant is born
symptoms that otherwise cant be explained
meconium below the level of vocal cords
seen in post mature babies
fetal hypoxia causes intestinal hyperperistalsis, passage of meconium, which is aspirated by fetus
imaging
aspiration of meconium – complete or partial obstruction of distal airways, lead to ball-valve effect
alternating areas of overinflation and atelectasis
chemical pneumonitis
pulmonary hypertension
air leaks
small pleural effusion
treatment
30% require mechanical ventilation
extracorporeal membrane oxygenation. Veno atrial ECMO one catheter in internal jugular vein, other in common carotid artery or veno venous method via double lumen catheter in internal jugular vein. VA ECMO allows bypassing lung when pulmonary vascular resistance is high
severe pulmonary hypertension treated with nitric oxide