Meconium Aspiration - Symptoms, Causes and Treatment

Meconium aspiration or or meconium aspiration syndrome (MAS) is a condition when a fetus or newborn inhales amniotic fluid mixed with its first feces (meconium). This condition can occur before, during, or after the birth process.

Meconium is a baby's first stool which is thick, sticky, and dark green in color. Generally, babies will pass meconium in the first 24–48 hours after birth. However, in some cases, the baby may pass meconium while still in the womb.

Causes of Meconium Aspiration

Meconium aspiration can occur when the fetus is stressed, then inhales meconium mixed with amniotic fluid. Stress that occurs in the fetus can also cause premature passage of meconium. Passing meconium prematurely can also increase the risk of meconium aspiration.

There are several conditions that can stress the fetus and increase the risk of meconium aspiration, including:

  • Pregnancy that is more than 40 weeks
  • Difficult or long labor
  • Health conditions experienced by pregnant women, such as hypertension or diabetes
  • Fetal medical conditions, such as hypoxia
  • Fetal growth disorders

Symptoms of Meconium Aspiration

Meconium is a baby's first stool, which is thick, sticky, and green in color. Passing meconium in the first 48 hours after birth is a sign of normal development of the baby's digestive tract.

However, when meconium is inhaled by the fetus before or during delivery, various complaints and symptoms will appear. In fact, if meconium to block the airways, the fetus can have difficulty breathing. This condition can be fatal.

There are several signs and complaints that can be experienced by babies who experience meconium aspiration, namely:

  • Respiratory problems, such as breathing too fast, difficulty breathing, the appearance of a "grok" sound when breathing
  • Stopped breathing or apnea
  • Cyanosis, which is characterized by bluish lips and skin
  • Babies appear weak or less active at birth

When to go to the doctor

Meconium aspiration can be seen and recognized when the baby is born. Doctors will immediately take action to overcome this condition. To monitor the health condition of pregnant women and fetuses, it is necessary to carry out routine pregnancy checks, according to doctor's recommendations.

Pregnant women who experience ruptured membranes, especially if the amniotic fluid looks cloudy, green, or smells bad, should immediately consult a doctor.

Meconium Aspiration Diagnosis

Meconium aspiration can be determined through examinations performed at birth. When the baby is born, the doctor will perform a thorough examination of the baby. One of the first tests that will be carried out is an Apgar score assessment, to ensure the baby is born healthy.

If the results of the assessment of the Apgar score are low, the doctor will provide first aid, while carrying out other follow-up examinations, such as:

  • Blood gas analysis, to evaluate oxygen and carbon dioxide levels
  • Chest X-ray, to see the condition of the baby's lungs

Meconium Aspiration Treatment

When the baby has meconium aspiration, the doctor will take action to remove the meconium from the airway. The doctor will perform suction (suction) from the baby's mouth, nose and throat if necessary.

If the baby is still not breathing and the Apgar score does not rise, the doctor will perform resuscitation to restore respiratory function. The doctor can also put on a breathing apparatus and move the baby to the neonatal intensive care unit (NICU) to undergo intensive care.

If needed, the doctor can also provide additional treatment in the form of:

  • Oxygen therapy, to ensure there is enough oxygen in the blood
  • Antibiotics, to treat infections
  • Surfactant, to help the lungs develop properly

In addition, the doctor will install a special warmer to prevent hypothermia and conduct regular blood tests to monitor the baby's condition.

Complications of Meconium Aspiration

If you get help quickly, a baby who has meconium aspiration can recover. However, if treated too late, this condition can be fatal. In addition, meconium aspiration can also increase the risk of several conditions, such as:

  • Inflammation and infection of the lungs due to accidentally inhaled meconium and enters the lung area
  • The lungs expand excessively and are damaged by meconium blocking the baby's airways.
  • Pneumothorax or excessive accumulation of air in the pleural cavity which makes it difficult for the lungs to expand
  • Persistent pulmonary hypertension in newborns, which is high blood pressure in the pulmonary vessels that can make it difficult for the baby to breathe
  • Permanent brain damage due to severe meconium aspiration conditions can limit oxygen to the brain

Meconium Aspiration Prevention

The best way to prevent meconium aspiration is to have regular prenatal checkups and prevent stress on the fetus.

If pregnant women have risk factors that can increase the risk of meconium aspiration, such as hypertension or diabetes, follow the advice and therapy given by your doctor.

Pregnant women are also required to maintain their health and avoid exposure to smoking smoke during pregnancy, because smoking can increase the risk of oxygen flow disturbances, and even lack of oxygen (hypoxia) in the fetus.