Meconium aspiration syndrome

Meconium aspiration syndrome is a common problem will be encountered in the delivery room. Meconium aspiration primarily affects term and postmature infants. The meconium-stained amniotic fluid may be aspirated by the fetus when fetal gasping or deep breathing movements are stimulated by hypoxia and vagal reflex. Meconium aspiration syndrome must be considered in any infant born through meconium-stained amniotic fluid who develops symptoms of respiratory distress. There is no specific treatment of meconium aspiration syndrome. The key to manage meconium aspiration lies in prevention during the prenatal period. The American Academy of Pediatrics Neonatal Resuscitation Program Steering Committee has promulgated the new guideline for management of the baby exposed to meconium that suction the trachea immediately after deliveries no longer than 5 seconds. Immediate tracheal intubation and suctioning is recommended only if the infant is not vigorous. Positive pressure ventilation should be avoided, if possible, until tracheal suctioning is accomplished. Conventional therapy for meconium aspiration syndrome is aimed at increasing oxygenation while minimizing the barotrauma that may lead to air leak syndromes. The amount of ventilatory support depends on the amount of respiratory distress. The optimal ventilatory modes in meconium aspiration syndrome are not known. Optimal dose, method, and timing of instillation of surfactant in meconium aspiration syndrome remain to be determined. The optimal time for initiation of inhaled nitric oxide remain to be determined. Inhaled nitric oxide should be instituted only at centers with extracorporeal membrane oxygenation availability. These patients may have suffered perinatal asphyxia, surveillance for any end-organ damage is essential. Complications are common and are associated with significant mortality.