Meconium stained amniotic fluid4/2/2023 ![]() ![]() Babies may have persistent pulmonary hypertension of the newborn, as a consequence.Persistent pulmonary hypertension of the newborn It is treated with administration of synthetic or animal surfactant. Surfactant replacement therapy has shortened the duration of the disease and significantly reduced mortality.Thus, every breath takes a lot of effort for relatively poor expansion. The baby must re-inflate the collapsed alveoli with every breath. A deficiency of surfactant produces high alveolar surface tension.Respiratory distress that usually occurs within four hours of birth and becomes persistently worse for 48 to 72 hours is known as infant respiratory distress syndrome.Complications Infant respiratory distress syndrome See the separate Meconium Aspiration article for further information. Endotracheal intubation at birth in otherwise healthy, term meconium-stained babies, is no longer recommended.If there is blood or if there are lumps of meconium in the oropharynx, suction should be used in the upper airways.The baby should be observed for signs of respiratory distress in the first hour of life, in the second hour and then two-hourly until 12 hours old.If the baby is in good condition (Apgar score >5, based on colour, tone, heart rate and breathing), there should be no suction.There should be no suction prior to delivery.Ensure that the advanced resuscitation unit and appropriately trained staff are available.If pH is <7.21, there should be emergency delivery. If there are signs of fetal distress, a fetal blood sample should be obtained.Transfer mother to obstetric-led care, if it is safe to do so and delivery is not imminent.This is defined as dark green or black amniotic fluid that is thick or tenacious, or any amniotic fluid that contains lumps of meconium.If significant meconium staining is noted in labour, there should be continuous electronic fetal monitoring.These recommendations are from the National Institute for Health and Care Excellence (NICE) guidance, 2014 which was updated in 2017. Maternal hypertension and pre-eclampsia.ĭeliveries complicated with meconium-stained amniotic fluid are associated with increased frequency of operative delivery, birth asphyxia, neonatal sepsis, and neonatal intensive care unit admissions compared to clear amniotic fluid. The figure quoted for low-risk infants born with meconium-stained liquor is around 12% at term. It is rare in babies born at <34 weeks of gestation. Meconium staining often occurs in conjunction with other causes of fetal distress. ![]() There are several pathological mechanisms participating in MAS, including antenatal infection/inflammation and activation of the inflammatory cascade, mechanical airway obstruction, inactivation of surfactant and persistent pulmonary hypertension. This can result in meconium aspiration syndrome (MAS). It is considered significant if dark green or black, with a thick, tenacious appearance.Ĭomponents of the meconium, especially the bile salts and enzymes, can cause serious complications if they are inhaled by the fetus at any stage of labour. This can vary from light to heavy staining. However, in some cases the meconium is passed while in utero, staining the amniotic fluid. Therefore, tracheal suction is recommended for infants born depressed and with thick meconium stained amniotic fluid.Meconium is a dark green liquid normally passed by the newborn baby, containing mucus, bile and epithelial cells. Conclusion: Amniotic fluid with thick meconium may cause more respiratory and other complications in neonates than amniotic fluid with thin meconium. Meconium aspiration syndrome and hypoxic ischemic encephalopathy were also significantly higher in infants with thick meconium. Results: Compared to neonates with thin meconium, those with thick meconium appeared to have significantly greater rates of acidemia, low APGAR scores at the 1th and 5th minutes, more need for resuscitation and higher mortality rate. Amniotic fluid was defined as thin (221 neonates) or thick (57 neonates) by a pediatrician. Method: We evaluated 278 meconium stained neonates between January 1993 ? February 1999. ![]() The purpose of this study was to evaluate neonates with meconium stained amniotic fluid and to investigate whether pulmonary disease and mortality were significantly greater in infants with thick meconium. 2001 6(1): 18-21 Evaluation and management of neonates with meconium stained amniotic fluid N.
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