Meconium aspiration syndrome

  • 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
  • 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
  • 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