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Meconium aspiration syndrome (MAS) is defined as respiratory failure in infants born in meconium-stained amniotic fluid, which is one of the feared complications. Proper monitoring and management of pregnancy helps prevent aspiration of meconium at birth as well as subsequent sequelae.
1. What is meconium?
Meconium is a waste product from the fetal gastrointestinal tract, dark green, viscous, consisting of water (70-80%), squamous cells, secretions from the digestive tract, fetal hair, amniotic fluid, glycoproteins, bile salts and intestinal epithelium... Meconium is sterile, which is the primary distinguishing factor from normal stool. Factors affecting fetal meconium excretion in utero include: placental anemia, pre-eclampsia, high blood pressure, oligohydramnios, maternal addiction to smoking, especially tobacco and cocaine. Inhaling meconium before or during labor can block the airways, interfere with gas exchange, and cause severe respiratory distress.
2. Causes of children inhaling meconium
Normal fetuses also have the phenomenon of expulsion of meconium in utero or during childbirth, this is a manifestation of the maturation of the gastrointestinal tract.
However, the increased expulsion of meconium before birth may be related to the stress of the fetus in utero due to: infection, difficult labor in the mother, compression of the baby's umbilical cord.. causes hypoxia to the fetus, stimulates the parasympathetic nervous system to increase intestinal activity, relaxes the anal sphincter and increases the expulsion of meconium into the amniotic fluid surrounding the fetus.
In utero, amniotic fluid goes out into the fetal trachea (the upper part of the respiratory tract), when the fetus has breathing movements in the uterus or when the baby has just been born, it will inhale amniotic fluid with meconium In the lungs, this breathing movement occurs when the fetus has a lack of oxygen due to: infection or the umbilical cord is compressed when the mother is in labor... The frequency of inhaling meconium is close to 9-25% in newborns. live infants. Nearly 5% of babies born with meconium-stained amniotic fluid will have meconium aspiration, and nearly 50% of these babies require mechanical ventilation after birth. Other risk factors for meconium aspiration syndrome include:
Difficult and prolonged delivery High gestational age (term pregnancy) > 41 weeks. The mother smokes heavily, has diabetes, high blood pressure (hypertension), respiratory disease or chronic cardiovascular disease. Complications of the umbilical cord Fetal growth retardation (a baby grows slowly in the uterus) Premature birth is not a risk factor for aspiration in meconium. In fact, this syndrome is very rare in babies born before 34 weeks.
However, the presence of meconium during labor and delivery is not always associated with fetal distress. Sometimes, babies without fetal distress still pass meconium before birth. Either way, a baby gasping for air or inhaling meconium can develop meconium aspiration syndrome. Although meconium aspiration syndrome is not usually life-threatening, it can cause significant health complications for infants. In particular, if this syndrome is severe or untreated, it can be fatal for the child.
3. Managing pregnancy to prevent aspiration of meconium
Early detection is the best preventative measure in preventing meconium aspiration syndrome . Prenatal fetal monitoring can determine if the baby is impaired.
Việc theo dõi thai nhi trước khi sinh có thể xác định liệu em bé có bị suy không
In particular, high-risk pregnancies such as intrauterine growth retardation, premature pregnancy, preeclampsia, high blood pressure, chronic cardiopulmonary disease, etc., should be closely monitored during pregnancy. and during birth. Good pregnancy management, obstetric care to reduce the rate of premature birth. For pregnant women ≥ 41 weeks, intervention is recommended rather than monitoring. When the amniotic fluid is found to be dark green, the pregnant woman should immediately notify the doctor so that she can closely monitor the fetal heart rate and fetal status, thereby taking early intervention measures to avoid complications. Your doctor can take steps to reduce the weakening of your baby during labor and reduce the chance of developing the syndrome. If the baby is impaired, the doctor will be ready to evaluate and treat the baby immediately if there are signs of meconium aspiration syndrome.
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