Meconium aspiration syndrome(MAS): Symptoms & Treatments
Symptoms
Meconium aspiration syndrome is defined as a case in which the amniotic fluid is manifested as a respiratory distress syndrome in a newborn born with meconium staining and the cause of which is unknown. Meconium aspiration syndrome is present in 5% of all cases, and meconium aspiration syndrome occurs in 10% to 15% of total labor. Meconium aspiration syndrome requires mechanical ventilation in 30% of patients and mortality rate is 3-5%.
Wrinkled skin, long nails may appear and meconium may be colored on the skin, under the fingernail, and on the umbilical cord. And if the meconium is released and aspirated by the perinatal period, it may be stretched. Symptoms such as rapid respiration, chest wall depression, cyanosis, pneumothorax, and hemiplegia may last for days to weeks and may be accompanied by pulmonary hypertension. On imaging, chest X-ray may show bilateral lung swelling, irregular lung decline, and atelectasis.
Treatments
If the amniotic fluid is stained in meconium, the patient should immediately remove the intubation and meconium in case of a decrease in muscle tension, a slow pulse, or decrease in respiratory ability. If mechanical ventilation is needed for respiratory failure, And the alveolar wall and the swelling should be reduced by keeping the expiratory time longer. The use of surfactant is also effective and High Frequency Ventilation can be used if it is difficult to maintain normal arterial blood gas concentration with mechanical ventilation. If persistent pulmonary arterial hypertension occurs, NO inhalation therapy should be given and finally ECMO may be considered. Prognosis is largely reduced by the spread of neonatal resuscitation, but damage to the central nervous system may affect prognosis, and chronic coughing or wheezing may occur in only 5 to 10 years of age.
Meconium aspiration syndrome is defined as a case in which the amniotic fluid is manifested as a respiratory distress syndrome in a newborn born with meconium staining and the cause of which is unknown. Meconium aspiration syndrome is present in 5% of all cases, and meconium aspiration syndrome occurs in 10% to 15% of total labor. Meconium aspiration syndrome requires mechanical ventilation in 30% of patients and mortality rate is 3-5%.
Wrinkled skin, long nails may appear and meconium may be colored on the skin, under the fingernail, and on the umbilical cord. And if the meconium is released and aspirated by the perinatal period, it may be stretched. Symptoms such as rapid respiration, chest wall depression, cyanosis, pneumothorax, and hemiplegia may last for days to weeks and may be accompanied by pulmonary hypertension. On imaging, chest X-ray may show bilateral lung swelling, irregular lung decline, and atelectasis.
Treatments
If the amniotic fluid is stained in meconium, the patient should immediately remove the intubation and meconium in case of a decrease in muscle tension, a slow pulse, or decrease in respiratory ability. If mechanical ventilation is needed for respiratory failure, And the alveolar wall and the swelling should be reduced by keeping the expiratory time longer. The use of surfactant is also effective and High Frequency Ventilation can be used if it is difficult to maintain normal arterial blood gas concentration with mechanical ventilation. If persistent pulmonary arterial hypertension occurs, NO inhalation therapy should be given and finally ECMO may be considered. Prognosis is largely reduced by the spread of neonatal resuscitation, but damage to the central nervous system may affect prognosis, and chronic coughing or wheezing may occur in only 5 to 10 years of age.
