PATHOPHYSIOLOGY » ALPASSAGE Of MECONIUM IN UTERO:MSAFeconium stained aminiotic fluid)may result from of ‘post ~ term fetus with rising motilin levels and normal gastrointestinal function ,vagal stimulation produced by cord or head compression ,or in utero fetal stress, » BLASPIRATION OF MECONILMLIn the presence of fetal stress gasping by the fetus can result in aspiration of meconium before,during or immediately foliowing deiivery Severe MAS appears to be caused by pathologic intrauterine processes ,primarily chronic hypoxia sacidosts ,and infection . > C.EFFECTS OF MECONIUM ASPIRATION: When aspirated into the Lungs meconium may stimulate the release of cytokines and vasoactive substances that result in cardiovascular _and Inflammatory responses-in the fetus and newborn .Meconium its self ,or the resultant. ‘chemical peumonitis,mechanically obstructs the small airways,causes atelectasis and a “ball-valve” effect with resultant alr rapping and possible air leak. Aspirated meconium {leads to vasospasm, hypertrophy of the pulmonary arterial musculature,and pulmonary: ‘hypertension that lead to extra puimonary right- to -ieft shunting through the ductus arteriosus or the foramen ovale and results in worsened ventilation ~ perfusian(y/ Qymismateh leading to severe artertal hypoxemia .Aspirated meconium alsa fnpibits surfactant funcPATHOPHYSIOLOGY Tnirauterine Hypoxia Acute or ChTonie + Respiratory Adapted from Pediatrics 1975,56206-13