Meconium Aspiration Syndrome (MAS) is a condition that occurs when a newborn inhales meconium (the baby's first faecal material) mixed with amniotic fluid into their lungs before, during, or after delivery. This can lead to breathing difficulties, lung damage, and other complications.

MAS is more likely to occur when a baby is distressed or overdue, but it can also occur in healthy babies. Depending on how bad the condition is, treatment may include oxygen therapy, mechanical ventilation, antibiotics, or other measures to help.

Common symptoms of meconium aspiration syndrome

One in seven pregnancies has meconium-stained amniotic fluid (MSAF), although only 5% of the newborns who get MSAF go on to have MAS. But a child who has trouble breathing and whose amniotic fluid is stained with meconium at birth should always be thought to have MAS, which is basically a clinical diagnosis.

MAS has several symptoms, some of which are more easily detectable than others. If you see any of the below-mentioned symptoms in your baby, consult a medical professional.

Breathing problems such as gasping and respiratory distress
Physical impairment in infants at birth
Dark, greenish staining of the amniotic fluid
Skin discoloration in infants
Reduced urine output
Peeling skin
Long fingernails

What causes meconium aspiration syndrome?

Although there is still much to learn about the causes of MAS, five key factors have been identified: meconium passage, aspiration, airway obstruction, inflammation, and surfactant inactivation.

The presence of MSAF is believed to be a sign of foetal stress. Placental insufficiency, maternal hypertension, pre-eclampsia, oligohydramnios with umbilical cord compression during delivery, infections, and maternal substance abuse (especially cocaine and nicotine) are risk factors for MSAF. MAS is caused by the aspiration of MSAF during intrauterine gasping or the first breaths after birth.

MSAF and MAS are more likely to happen to babies whose mothers have HIV, but the effects of the HIV infection and anti-retroviral drugs are still unknown.

MASF is a common finding, but it is not necessarily related to MAS. Infection can cause uterine stress, which can lead to early foetal meconium passage.

Meconium is thicker and darker than infant stools. It develops as a result of the buildup of secretions and foetal cell waste (skin, gastrointestinal, and hair). Aspiration of these substances causes airway obstruction and inflammation. The newborn experiences respiratory discomfort as a result of these mechanisms.

When should you see a doctor?

Term and post-term newborns who are born with meconium-stained amniotic fluid commonly experience meconium aspiration (fetal stool). Less than 10% of children born with meconium-tinted amniotic fluid experience MAS. It is a significant factor in neonatal respiratory distress, so it needs to be recognised and treated right away.

Parents must be aware that it mostly consists of supportive care and needs admission to the neonatal critical care unit. With prompt diagnosis and treatment, most newborns make a full recovery. To allow for close monitoring, all infants born through MSAF who exhibit respiratory distress must be admitted to the neonatal intensive care unit (NICU).

Treatment of Meconium Aspiration Syndrome

The goals of MAS treatment include preventing or resolving infection, metabolic disorders, brain injury, reducing stress, and treating respiratory problems. According to the general neonatal resuscitation recommendations, newborns with MSAF should receive routine neonatal care while being watched for indications of distress. Although early detection and support can improve outcomes and lower morbidity and mortality, MAS management is primarily supportive.

The following courses of treatment and support are offered for curing Meconium Aspiration Syndrome:

Oxygen therapy: A person with MAS needs extra oxygen to prevent tissue hypoxia and improve oxygenation. The goal is for oxygen saturation to be above 90%.
Ventilatory support: There are no particular ventilation techniques. To help optimise oxygenation and ventilation, serial ABG and oxygenation monitoring are essential.

After receiving treatment, many infants with MAS recover within a few days. Babies that have severe MAS will require additional care, such as antibiotics, oxygen therapy, time on a ventilator, nitric oxide inhalation therapy, and more blood testing. If cared for by an experienced medical team that acts swiftly, the majority of infants recover from MAS.

Request an appointment at Apollo Cradle, Bengaluru - Brookefield. Call 1860-500-1066 to book an appointment.

1. Can I have a normal delivery if my baby has meconium-stained amniotic fluid?

Yes, you can have a normal delivery even if your baby has passed meconium into the amniotic fluid. Regardless of the type of delivery—normal or C-section—it should take place in a facility with access to a Neonatal Intensive Care Unit. This will make it possible for skilled personnel, such as a midwife, nurse, paediatrician or neonatologist, and respiratory therapist, to be present for the delivery and prepared in case breathing support is ultimately required.

2. Can meconium aspiration be avoided?

Meconium aspiration can happen before delivery even in the absence of labour, although in many infants, this issue could be avoided by careful suctioning at birth.

3. Can meconium cause long-term damage to the baby?

Meconium aspiration is typically identified and treated shortly after birth without causing the baby any long-term harm. The infant, however, may experience irreversible hearing loss, lung problems, or brain damage if the right medical care is not provided. Testing for these injuries should be done on an infant with MAS.

4. Do babies fully recover from meconium aspiration?

With timely diagnosis and proper treatment, a baby can fully recover from MAS. However, if left untreated, MAS can be fatal.