Meconium Aspiration

Syndrome
(MAS)
 What is Meconium Aspiration
Syndrome?
 MAS can happen before, during, or after labor and
delivery when a newborn inhales (or aspirates) a mixture
of meconium and amniotic fluid (the fluid in which the
baby floats inside the amniotic sac). Meconium is the
baby's first feces, or poop, which is sticky, thick, and
dark green and is typically passed in the womb during
early pregnancy and again in the first few days after
birth.
This syndrome is also called as “Neonatal Aspiration”.
SAMPLE
OF MAS
Who is affected by meconium
aspiration?
Meconium is passed into the amniotic
fluid in about 10 percent of births. It
usually occurs in babies born at term
(37 to 41 weeks) or post-term (after 42
weeks).
How does this occur?
 Before a baby is born, fluid usually moves in and out
of the trachea (the upper part of the airway) only.
Meconium can be inhaled into the lungs if the baby
gasps while still in the womb or during the initial
gasping breaths after delivery.
 This gasping usually happens because a problem
(such as an infection or compression of the umbilical
cord) made it hard for the baby to get enough oxygen
before birth.
Risk Factors of
MAS
MAS is often related to fetal stress. This can be caused
by problems in the womb, such as infections, or by
difficulties during the birth. A distressed baby may have

hypoxia (decreased oxygen), which can make the

baby's intestinal activity increase and cause relaxation

of the anal sphincter (the muscular valve that

controls the passage of feces out of the anus). This
relaxation then moves meconium into the amniotic fluid
that envelops the baby.
 Here are other risk factors of MAS:

a long or difficult delivery

advanced gestational age (or post maturity)
a mother who smokes cigarettes heavily or who
has diabetes, high blood pressure (hypertension), or
chronic respiratory or cardiovascular disease
umbilical cord complications
poor intrauterine growth (poor growth of the baby
while in the uterus)
 Signs
&
Symptoms
of Meconium Aspiration
Syndrome
 The following are the most common symptoms of meconium
aspiration.
However, each baby may experience symptoms differently.
Symptoms may include:

•Retractions (pulling in of the chest wall)

•Grunting sounds with breathing
•Cyanosis (blue coloring)
•Overdistended chest because of trapped air
meconium or dark green streaks or stains in the amniotic fluid
discoloration of the baby's skin — either blue (cyanosis) or green
(from being stained by the meconium)
•problems with breathing — including rapid breathing
(tachypnea), labored (difficulty) breathing, or suspension of
breathing (apnea)
•low heart rate in the baby before birth
•low Apgar score (given to newborns just after birth to quickly
evaluate color, heartbeat, reflexes, muscle tone, and breathing)
•limpness in the baby
•postmaturity (signs that a baby is overdue, such as long nails)
Diagnostic Tests
for MAS
 A diagnosis is made based on your newborn’s symptoms
and the presence of meconium in the amniotic fluid.
Your doctor will listen to your infant’s chest with a
stethoscope to detect sounds of abnormal breathing. There
are a few methods commonly used to confirm the
diagnosis:

•blood gas test to evaluate oxygen and carbon dioxide levels

•chest X-ray to see if material has entered your newborn’s
lungs
 Management /
Treatment given to
this syndrome’s
patients
•If MAS occurs, your newborn will need immediate treatment to remove
the meconium from the upper airway.
•After delivery, your doctor will immediately suction the nose, mouth,
and throat.
•If your baby isn’t breathing or responding well, a tube may be placed in
your newborn’s windpipe (trachea) to suction the fluid containing
meconium from the windpipe. The suctioning may then continue until
no meconium is seen in the material removed.
•If your newborn still isn’t breathing or has a low heart rate, your
doctor will use a bag and mask to help them breathe. This will deliver
oxygen to your baby and help inflate their lungs.
•Your doctor may need to place a tube in your newborn’s windpipe to
help them breathe if the infant is very ill or isn’t breathing on their own.
•After emergency treatment has been provided, your newborn may be
placed in a special care unit to observe their breathing. Additional
treatment may be needed to avoid complications of MAS. Five common
treatments include:
•oxygen therapy to make sure there is enough oxygen in the blood
•the use of a radiant warmer to help your baby maintain body
temperature
•antibiotics such as ampicillin and gentamicin to prevent or treat an
infection
•the use of a ventilator (a breathing machine) to help your infant breathe
•extracorporeal membrane oxygenation (ECMO) if your baby isn’t
responding to other treatments or has high blood pressure in the lungs (for
this treatment, a pump and machine that performs the function of the
 Caregiver
Responsibilities
A special care team should be present when the baby is born if traces of meconium are
found in the amniotic fluid.
This happens in more than 10% of normal pregnancies. If the baby is active and crying, no
treatment is needed.

If the baby is not active and crying right after delivery, the team will:

> Warm and maintain normal temperature

Dry and stimulate the baby.

This intervention is often all babies need to begin breathing on their own.If the baby is not
breathing or has a low heart rate:

The team will help the baby breathe using a face mask attached to a bag that delivers an
oxygen mixture to inflate the baby's lungs.

The infant may be placed in the special care nursery or newborn intensive care unit in order
to be watched closely.