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Meconium Aspiration Syndrome

Signs, Symptoms and Treatment of MAS

By Lisa A. Goldstein

"Meconium is sticky and difficult for the normal protective mechanisms of the lungs to remove," Dr. Hirschman says. "It blocks the absorption of oxygen from the air, and can completely block the smaller airways. The thicker the meconium, the more the danger. If meconium is seen in the amniotic fluid, the obstetrician will carefully suction all the fluid from the baby's mouth, throat and nose to prevent aspiration. A pediatrician or anesthesiologist may even pass a tube into the newborn's trachea, the windpipe, to try to remove any meconium that has been aspirated. However, there are no effective methods of removing the substance once it has made its way down into the infant's lungs." Treatment is primarily supportive and consists of oxygen delivery, usually under pressure using mechanical ventilation, maintenance of fluid, electrolyte and nutritional balance and management of the many complications of the syndrome and even of its treatment, Dr. Hirschman says. "This will invariably require a prolonged stay in neonatal ICU, and may even require continued oxygen supplementation after discharge from the hospital," he says.

Before birth, lack of fetal movement may be a sign that the fetus is experiencing some stress, which may indicate that the fetus will pass meconium, Dr. Hamvas says. Other than seeing the green-stained amniotic fluid once the water has broken, however, there are no symptoms. Once the baby is born, difficulty with breathing that persists beyond the first 10 to 20 minutes of the transition period may indicate MAS.

Most of the time, babies will recover uneventfully from MAS, though it may require a hospitalization beyond the normal two-to-four-day stay, Dr. Hamvas says. In the more severe cases, the risks to the baby are those associated with needing a respirator to support gas exchange, he adds. Sometimes babies will develop air leaks from their lungs and require a tube to drain the air that has collected outside the lungs but within the chest.

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