Prevention and management of meconium aspiration syndrome
- Joseph A Garcia-Prats, MD
Joseph A Garcia-Prats, MD
- Section Editor — Neonatology
- Professor of Pediatrics
- Baylor College of Medicine
Meconium aspiration syndrome (MAS) is defined as respiratory distress in newborn infants born through meconium-stained amniotic fluid (MSAF) whose symptoms cannot be otherwise explained . MAS can present with varying degrees of severity from mild respiratory distress to life-threatening respiratory failure. Coordination of care between the obstetric and neonatal team is important to reduce the incidence of MAS, and to identify and provide emergent therapy in those who develop MAS to reduce morbidity and mortality .
The prevention, management, and outcome of MAS will be reviewed here. The pathophysiology, clinical features, and diagnosis of MAS are discussed separately. (See "Clinical features and diagnosis of meconium aspiration syndrome".)
Because of the potential for poor outcome, the best approach for managing MAS is prevention.
Intrapartum management — Intrapartum care to reduce the incidence of MAS includes:
●Prevention of fetal hypoxia, which is thought to be an important contributor to the pathogenesis of MAS (see "Clinical features and diagnosis of meconium aspiration syndrome", section on 'Pathophysiology')
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- Intrapartum management
- - Prevention of fetal hypoxia
- - Prevention of postmature delivery
- - Amnioinfusion
- Delivery room management
- - Obstetrical care
- - Neonatal care
- Respiratory management
- - Oxygen therapy
- - Assisted ventilation
- - Surfactant
- - Nitric oxide
- - Extracorporeal membrane oxygenation (ECMO)
- Circulatory support
- Pulmonary sequelae
- Neurologic outcome
- SUMMARY AND RECOMMENDATIONS