The clinical condition meconium aspiration syndrome causes respiratory failure. It occurs in infants delivered via meconium-tainted amniotic fluid. It might be mild, moderate, or severe in terms of severity. Due to meconium discharge in amniotic fluid before 34 weeks of pregnancy, meconium aspiration syndrome is most frequently observed in near-term, term, or post-term neonates. (Monfredini et al.,2021). Meconium is a blackish-green, pure, inert, dense, sticky, and viscous substance composed of water, gastrointestinal secretions, pancreatic fluids, skin, bile, mucus, amniotic fluid, and blood glycoproteins, among other things. Meconium is commonly discovered in the gut of the fetus and infant within hours of birth in their first feces. On the other hand, Meconium can be discharged early in the fetus, resulting in meconium aspiration syndrome.
The signs and symptoms of meconium aspiration syndrome are experienced differently by each neonate, but some of the most common signs and symptoms include; tachypnea (Monfredini et al.,2021). In this situation, the neonate experiences abnormal or labored breathing. Another symptom is abnormal sounds made during breathing, such as grunting. Cyanosis is another sign; this is noted as the color of the neonate’s skin, nails, lips, and around the eyes is a bluish/greyish color. The neonate also experiences respiratory retractions. This is the pulling in of the neonate’s chest wall. The newborn also experiences low blood pressure.
The neonate will also show signs of a hyper-expanded and barrel-shaped thorax due to hyperinflation (Monfredini et al.,2021). The neonate’s low Apgar score is another sign and symptom of meconium aspiration syndrome. An Apgar score is a test done on the newborn one to five minutes after birth. The score determines the newborn’s muscle tone, heartbeat, reflexes, respiration, and color. The neonate will also show signs of a limp body, characterized by the newborn’s lack of firmness or structure.
Some of the clinical features used to determine meconium aspiration syndrome in a neonate are reduced urine output. The neonate also experiences hypoxemia, an oxygen deficit in the bloodstream. Hypoxemia results in acidosis. Acidosis is the buildup of acid in the bloodstream. A combination of hypoxemia and acidosis causes the neonate to experience pulmonary hypertension (Monfredini et al.,2021). This could be fatal to the neonate as the arteries to the lungs remain constricted, limiting blood flow to the lungs. Finally, the respiratory findings of the newborn range from mild to moderate to severe.
The diagnosis of meconium aspiration syndrome is commonly based on maternal history, such as whether it was a whole or post-term pregnancy or the presence or lack of Meconium (Monfredini et al.,2021). The neonate’s clinical features, signs, and symptoms are also incorporated during diagnosis. Aside from this information, several tests are conducted to make a conclusive diagnosis of meconium aspiration syndrome.
These tests include; an arterial blood gas (ABG). An ABG test measures the oxygen and carbon dioxide levels and the blood’s PH balance. In this case, it will help determine the degree of respiratory failure in the neonate (Sayad et al.,2020). In severe cases of meconium aspiration, the ABG test will show hypoxemic, hypercapnic, and respiratory acidosis. Meconium aspiration syndrome may cause sepsis. As a result, blood and tracheal cultures will be needed to determine this. A pulse oximetry test may also be necessary to diagnose the syndrome (Sayad et al.,2020). It is a measure of the degree of shunting in the body. Finally, an echocardiography (ECG) is necessary to assess the neonate’s heart function and screen for signs of persistent pulmonary hypertension in the newborn (PPHN).
References
Monfredini, C., Cavallin, F., Villani, P. E., Paterlini, G., Allais, B., & Trevisanuto, D. (2021). Meconium aspiration syndrome: a narrative review. Children, 8(3), 230.
Sayad, E., & Silva-Carmona, M. (2022). Meconium aspiration. In StatPearls [Internet]. StatPearls Publishing.
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