Management of meconium aspiration syndrome

Summary 

Meconium aspiration syndrome (MAS) occurs in 2–22% of babies born through meconium-stained amniotic fluid and carries significant mortality and morbidity. It is diagnosed in a baby delivered through meconium-stained amniotic fluid who develops signs of respiratory distress in the presence of a supportive chest X-ray.

Appropriate intrapartum care with early detection and management of fetal hypoxia is important in minimising the risk from meconium staining of amniotic fluid. However, there is no evidence to support the widespread practice of routine pharyngeal suction and/or endotracheal intubation in these babies. Treatment of established MAS is based on respiratory support with conventional mechanical ventilation and surfactant therapy. Alternative strategies such as inhaled nitric oxide and high-frequency ventilation and/or extracorporeal membrane oxygenation (ECMO) are reserved for babies with severe hypoxaemic respiratory failure with or without persistent pulmonary hypertension of the newborn.

Keywords: Meconium aspiration syndrome, Newborn, Infant, Hypoxaemic respiratory failure