Advertisement

Neonatology pp 791-799 | Cite as

Meconium Aspiration Syndrome

  • Simone Pratesi
  • Carlo Dani
Reference work entry

Abstract

Meconium aspiration syndrome is a disease characterized by a respiratory insufficiency of variable severity, where lung injury probably starts prenatally. The role of meconium in the pathogenesis of the disease is still partly unknown, while increasing evidence suggests that chronic in utero insults may be responsible for starting lung damage as well as triggering fetal distress and meconium passage into the amniotic fluid. Survival rate has greatly improved over the last three decades with newer and more efficient modalities of treatment. On the other hand, concern exists about the long-term neurodevelopmental and pulmonary outcome of survivors.

Abbreviations

ECMO

Extracorporeal membrane oxygenation

HFOV

High-frequency oscillatory ventilation

iNO

Inhaled nitric oxide

MAS

Meconium aspiration syndrome

MSAF

Meconium-stained amniotic fluid

References

  1. ACOG Committee Obstetric Practice (2006) ACOG Committee Opinion Number 346, October 2006: amnioinfusion does not prevent meconium aspiration syndrome. Obstet Gynecol 108:1053CrossRefGoogle Scholar
  2. ACOG Committee on Obstetric Practice (2007) ACOG Committee Opinion No. 379: Management of delivery of a newborn with meconium-stained amniotic fluid. Obstet Gynecol 110(3):739CrossRefGoogle Scholar
  3. Cayabyab RG, Kwong K, Jones C et al (2007) Lung inflammation and pulmonary function in infants with meconium aspiration syndrome. Pediatr Pulmonol 42:898–905CrossRefGoogle Scholar
  4. Chettri S, Adhisivam B, Bhat BV (2015) Endotracheal suction for nonvigorous neonates born through meconium stained amniotic fluid: a randomized controlled trial. J Pediatr 166(5):1208–1213.e1CrossRefGoogle Scholar
  5. Cleary GM, Wiswell TE (1998) Meconium-stained amniotic fluid and the meconium aspiration syndrome: an update. Pediatr Clin N Am 45:511–529CrossRefGoogle Scholar
  6. Dargaville PA, Copnell B, Tingay DG et al (2008) Refining the method of therapeutic lung lavage in meconium aspiration syndrome. Neonatology 94:160–163CrossRefGoogle Scholar
  7. El Shahed AI, Dargaville P, Ohlsson A, Soll RF (2014) Surfactant for meconium aspiration syndrome in term and late preterm infants. Cochrane Database Syst Rev 12, CD002054Google Scholar
  8. Finer NN, Barrington KJ (2006) Nitric oxide for respiratory failure in infants born at or near term. Cochrane Database Syst Rev 4, CD000399Google Scholar
  9. Garg N, Choudhary M, Sharma D, Dabi D, Choudhary JS, Choudhary SK (2016) The role of early inhaled budesonide therapy in meconium aspiration in term newborns: a randomized control study. J Matern Fetal Neonatal Med 29(1):36–40CrossRefGoogle Scholar
  10. Geiger R, Kleinsasser A, Meier S et al (2008) Intravenous tezosentan improves gas exchange and hemodynamics in acute lung injury secondary to meconium aspiration. Intensive Care Med 34(2):368–376CrossRefGoogle Scholar
  11. Ghidini A, Spong CY (2001) Severe meconium aspiration syndrome is not caused by aspiration of meconium. Am J Obstet Gynecol 185:931–938CrossRefGoogle Scholar
  12. Hahn S, Choi HJ, Soll R, Dargaville PA (2013) Lung lavage for meconium aspiration syndrome in newborn infants. Cochrane Database Syst Rev 4, CD003486Google Scholar
  13. Herting E, Rauprich P, Stichtenoth G et al (2001) Resistance of different surfactant preparations to inactivation by meconium. Pediatr Res 50:44–49CrossRefGoogle Scholar
  14. Kinsella JP, Truog WE, Walsh WF et al (1997) Randomized, multicenter trial of inhaled nitric oxide and high-frequency oscillatory ventilation in severe, persistent pulmonary hypertension of the newborn. J Pediatr 131:55–62CrossRefGoogle Scholar
  15. Kugelman A, Gangitano E, Taschuk R et al (2005) Extracorporeal membrane oxygenation in infants with meconium aspiration syndrome: a decade of experience with venovenous ECMO. J Pediatr Surg 40:1082–1089CrossRefGoogle Scholar
  16. Petrikovsky B (2004) In utero meconium suctioning may prevent meconium aspiration. Fetal Diagn Ther 19:533e5CrossRefGoogle Scholar
  17. Rais-Bahrami KRO, Seale WR, Short BL (1997) Effect of nitric oxide in meconium aspiration syndrome after treatment with surfactant. Crit Care Med 25(10):1744–1747CrossRefGoogle Scholar
  18. Singh BS, Clark RH, Powers RJ, Spitzer AR (2009) Meconium aspiration syndrome remains a significant problem in the NICU: outcomes and treatment patterns in term neonates admitted for intensive care during a ten-year period. J Perinatol 29:1–7CrossRefGoogle Scholar
  19. Tessler R, Pan J, Holmer Fiori H, Belik J (2008) Human meconium has a pulmonary vascular and airway smooth muscle relaxant effect. Pediatr Res 64(1):24–28CrossRefGoogle Scholar
  20. Thureen PJ, Hall DM, Hoffenberg A, Tyson RW (1997) Fatal meconium aspiration in spite of appropriate perinatal airway management: pulmonary and placental evidence of prenatal disease. Am J Obstet Gynecol 176:967–975CrossRefGoogle Scholar
  21. Tripathi S, Saili A (2007) The effect of steroids on the clinical course and outcome of neonates with meconium aspiration syndrome. J Trop Pediatr 53:8–12CrossRefGoogle Scholar
  22. Walsh MC, Fanaroff JM (2007) Meconium stained fluid: approach to the mother and the baby. Clin Perinatol 34:653–665CrossRefGoogle Scholar
  23. Ward M, Sinn J (2003) Steroid therapy for meconium aspiration syndrome in newborn infants. Cochrane Database Syst Rev;(4) CD003485Google Scholar
  24. Wiswell TE, Gannon CM, Jacob J et al (2000) Delivery room management of apparently vigorous meconium-stained neonate: results of the multicenter, international trial. Pediatrics 105:1–7CrossRefGoogle Scholar
  25. Wyckoff MH, Aziz K, Escobedo MB, Kapadia VS et al (2015) Part 13: neonatal resuscitation: 2015 American Heart Association Guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Pediatrics 136(Suppl 2):S196–S218CrossRefGoogle Scholar
  26. Xu H, Hofmeyr J, Roy C, Fraser WD (2007) Intrapartum amnioinfusion for meconium-stained fluid: a systematic review of randomised controlled trials. BJOG 114:383–390CrossRefGoogle Scholar
  27. Zagariya A, Bhat R, Navale S et al (2006) Inhibition of meconium-induced cytokine expression and cell apoptosis by pre-treatment with captopril. Pediatrics 117(5):1722–1727CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Neonatal Intensive Care UnitCareggi University HospitalFlorenceItaly
  2. 2.Università degli Studi di FirenzeFlorenceItaly

Personalised recommendations