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Meconium Aspiration Syndrome (MAS) is caused by a child choking on amniotic fluid contaminated with meconium. Choking often occurs inside the uterus. This causes respiratory obstruction and breathing problems in the baby. What are the causes and symptoms of MAS? How is the meconium aspiration syndrome treated?

Meconium aspiration syndrome(MAS ormeconium aspiration syndrome ) occurs in 2-10 percent of newborns who have meconium in the waters fetal. It mainly affects newborns born at delivery, occasionally premature babies born between 34-37. week of pregnancy.

Meconium aspiration syndrome - risk factors

What increases the risk of meconium excretion by the child to the amniotic fluid, and thus the occurrence of her aspiration syndrome?

  • transferred pregnancy
  • pre-eclampsia and eclampsia
  • maternal hypertension
  • gestational diabetes
  • fetal heart abnormality
  • intrauterine growth inhibition syndrome
  • abnormal fetal biophysical profile
  • low water
  • significant mother's nicotinism
  • chronic diseases of the lungs and circulatory system in the mother

Meconium aspiration syndrome - causes

The most common cause of meconium excretion into amniotic fluid is fetal hypoxia or intrauterine infection. Hypoxia also causes the baby to try to breathe inside the womb and to choke on contaminated amniotic fluid. As a result, a child after birth may develop:

  • bronchiolar obstruction - formation of atelectasis foci in the lungs
  • alveolar damage and chemical pneumonia
  • small bronchial obstruction, pneumothorax is a complication of MAS in 20-50 percent of newborns
  • development of persistent pulmonary hypertension of newborns due to changes in the pulmonary vascular bed resulting from hypoxia

Meconium aspiration syndrome - symptoms

The clinical symptoms of MAS depend on how hypoxic the child is and the amount, viscosity, and density of the amniotic fluid the child has choked on:

  • thick green amniotic fluid in the newborn's airways
  • green skin discoloration,nails, umbilical cords
  • cyanosis
  • bad general condition of the newborn after delivery: bradycardia, decreased muscle tone, pale skin, respiratory disorders or lack of respiratory function, resulting in a low Apgar score

Meconium aspiration syndrome - treatment

The general rule in the case of children with meconium aspiration syndrome is to minimize procedures, care and diagnostics, because the child's anxiety, pain and agitation may aggravate hypoxia, especially in patients with concomitant persistent pulmonary hypertension of newborns.

For meconium aspiration syndrome, the prognosis depends on the severity of the child's condition.

First of all, meconium is suctioned from the mouth, nose, trachea and oxygen therapy is used - about 30 percent of young patients require connection to a respirator.

The baby is given antibiotics, and often sulfactants or albumin are given to strengthen the immune system. In the case of coexistence of persistent pulmonary hypertension of newborns, inhaled nitric oxide (iNO) is used. When blood pressure is low, drips are given.

In some cases, parenteral nutrition (or via an intestinal tube) is also used so that the child does not tire of feeding orally.

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