PRE-DISPOSING FACTORS mat're #!

tract in post term %et's( presence o% peristalsis( contraction o% the anal sphincter Vagal stim'lation $y cor or hea compression may $e associate )ith passage o% meconi'm SYSTEMS INVOLVED Repiratory System

RISK FACTORS Maternal HT Maternal DM Maternal heavy cigarette smoking Maternal chronic respiratory or CV Dx Post term pregnancy Pre-eclampsia/eclampsia Oligohy ramnios !"#R Poor $iophysical pro%ile &$normal %etal HR pattern

CELLULAR CHANGES
ball valve phenomenon( air %lo)s past meconi'm 'ring inspiration trappe istally 'ring expiration( lea ing to increase expiratory l'ng resistance( %'nctional resi 'al capacity* air)ays an l'ng parenchyma $ecome in%iltrate )ith large n'm$ers o% polymorphon'clear le'kocytes an macrophages* release o% vasoactive me iators( s'ch as eicosanoi s( en othelin-+ an prostaglan in ,Meconi'm isplaces s'r%actant %rom the alveolar s'r%ace an inhi$its its s'r%ace tension lo)ering a$ility*

ETIOLOGY The passage o% meconi'm %rom the %et's into amnion

ANATOMICAL CHANGES "#Me$han%$al Ob&'()$'%on o* 'he A%(+a, -# Pne)mon%'%& .#P)lmona(, va&o$on&'(%$'%on /# S)(*a$'an' %na$'%va'%on ON

PHYSIOLOGIC MANIFESTATION EFFECT ON ODILY F!NCTION. /0one

RECOVERY CL# MANIF# Patient<s con ition has improve $'t is still 'n er o$servation prior to ischarge

CLINICAL MANIFESTATION Peeling skin( long %ingernails( an ecrease vernix* nails )ill $ecome staine a%ter 1 ho'rs an vernix a%ter +- to +2 ho'rs o% expos're* chest $arrel-shape ( increase anterior-posterior iameter rales an rhonchi -imme iately a%ter $irth* respiratory istress( tachypnea an cyanosis* intercostal an s'$costal retractions an a$ ominal 3para oxical4 $reathing( gr'nting an nasal %laring*

LA ORATORY FINDINGS "rinalysis 8 C9C( &PC( 9T 8 R9C is normal( Hemoglo$in is normal( Hematocrit is normal( 59C is a$ove normal( 0e'trophils is $elo) normal(:ymphocytes is a$ove normal( ,osinophils is normal( Platelet co'nt is normal C;:( &P:( a$ omen

COMPLICATIONS Meconi'n aspiration pn'emonia ,mphysema Meconi'm aspiration syn rome Pne'mothorax respiratory istress COMPLICATIONS rome 3RDS4* or +*Osteoporosis syn 35eakene %ragile $ones 'e to corticosteroi s -(High $loo press're 6*Damage to arteries 2*High $loo s'gars 7*!n%ections 1*Cataracts

FINAL DIAGNOSIS Th%$0l, Me$on%)m S'a%ne1 Amn%o'%$ Fl)%1

2-RAY /Reveale minimal gravitational shi%t o% the ple'ral %l'i to the epen ent si e