Fetal Meconium and Meconium Aspiration Syndrome

Meconium is a baby’s first bowel movement, which is sterile, tar-like and contains intestinal cells, bile, amniotic fluid and water. While meconium does not always present a serious problem, it can in certain situations threaten the life of your unborn child.

Meconium Aspiration Syndrome (MAS) is a serious condition that arises when your child takes his or her first breath and inhales a combination of meconium and amniotic fluid, causing a partial or complete blockage of the airways. MAS is associated with fetal distress, which should alert your medical providers that your baby is not doing well or is becoming excessively fatigued. If meconium was present and your doctor failed to take proper action, Stern Law, PLLC can help you protect your legal rights. Please call (800) 462-5772 for a free consultation.

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What causes meconium aspiration syndrome?

When your child’s oxygen supply is limited as a result of being in distress, his or her intestinal tract may become stimulated, causing the relaxation of the anal sphincter and ultimate release of meconium into the surrounding amniotic fluid. Although the release of meconium by itself is not necessarily life threatening, it can cause complications if inhaled by your unborn child.

In general, there are several risk factors associated with the development of meconium aspiration syndrome, including:

• Advanced maternal age;
• Post-term pregnancy;
• Exposure to teratogens, including chemicals, alcohol and cigarette smoke;
• Gestational diabetes;
• Prolonged labor;

• Gestational hypertension;
• Maternal cardiovascular disease;
• Maternal respiratory disease;
• Umbilical cord complications;
• Placental complications;
• Poor fetal intrauterine growth.

The signs and symptoms of meconium aspiration syndrome

There are several signs and symptoms of meconium aspiration syndrome that may manifest during labor or after your child is born, such as:

• The presence of dark green streaks or strains in the amniotic fluid;
• Discoloration of a baby’s skin at birth;
• Low fetal heart rate before birth;
• Rapid, labored or completely suspended breathing;
• A low Appearance, Pulse, Grimace, Activity, Respiration, or Apgar score – a test administered to newborns right after birth to quickly evaluate color, heartbeat, reflexes, muscle tone, and breathing;
• Signs of fetal post-maturity, such as long nails, hair, etc.;
• Limpness, or a lack of response to stimuli in a newborn.

Diagnosis and treatment

If your baby is thought to be experiencing meconium aspiration syndrome, medical treatment should be administered during the delivery process. If your baby is limp or shows signs of labored breathing at birth, a doctor may insert a laryngoscope into his or her trachea in order to remove any meconium that may be present. The doctor may also suction out your baby’s mouth and nose to further facilitate normal breathing in the newborn. A doctor will thoroughly examine your baby after birth and may order a number of tests should MAS be suspected, including a blood test known as a blood gas analysis and a chest X-ray to determine if your child is receiving enough oxygen.

In the event that your baby who previously suffered from meconium aspiration syndrome then appears to be active, breathing well and responding favorably to stimuli, the delivery team members will continue to monitor your baby’s breathing and vital signs until they determine that your child is out of the danger zone. Your baby will likely be observed for 24 to 48 hours after birth to watch for grunting, cyanosis (bluish purple skin discoloration demonstrating low oxygen saturation levels), and any increases in your baby’s respiration and heart rates.

Should your child remain unstable postpartum and continue to have trouble breathing, the delivery team’s first priority is to ensure that your baby is supplied with enough oxygen. Further treatment may include the following, which depends upon the severity of the child’s symptoms:

• Breathing support – This is administered through mechanical ventilation or the use of a nasal cannula;
• Intravenous fluids;
• IV antibiotics;
• Rescue therapy – This therapy involves nitric oxide which is incorporated into a ventilator’s oxygen supply in order to dilate your baby’s pulmonary blood vessels, which facilitates more blood flow and oxygen to your baby’s lungs;
• Surfactant therapy – This method is used to keep your baby’s pulmonary air sacs open;
• Routine blood sampling – This assesses your baby’s oxygenation and ventilation levels;
• Extra corporeal membrane oxygenation – This is a form of cardiopulmonary bypass where a heart and lung machine temporarily supplies blood and oxygen to your baby’s body;
• High frequency oscillation – This special type of ventilator vibrates oxygen enriched air into your baby’s lungs.

Meconium aspiration syndrome risks and potential long-term complications

Babies who have been severely affected by meconium aspiration syndrome and require mechanical ventilation may be at risk for developing several serious medical conditions, such as:

• Pneumothorax, or a collapsed lung;
• Pneumonia;
• Bronchopulmonary dysplasia;

• Pulmonary hypertension;
• Hearing loss;
• Chronic lung disease.

Prevention

A pregnant woman should inform her doctor if she notices meconium in the amniotic fluid when her water breaks or if the fluid contains dark green stains or streaks. A doctor should also use a fetal monitor during labor to monitor whether the unborn child is experiencing fetal distress. If it is established that meconium is present, your doctor may recommend an amnio infusion, which is a procedure where saline is used to dilute amniotic fluid that contains meconium and, effectively, wash it out before your child has the chance to inhale it at birth.

Meconium aspiration syndrome is a condition that must be appropriately addressed by health care practitioners. They are responsible for your health and that of your baby before, during and after labor and delivery. For a free consultation to discuss your legal options, please call Stern Law, PLLC (800) 462-5772 or contact us online today.