Overview

• Newborn aspirates meconium (first stool of an infant) into the lungs prior to or during birth. Causes respiratory distress.
• Risk Factors → post-term delivery (>40 weeks - SIGNIFICANT RF), prolonged labour, chorioamnionitis, pre-eclampsia, hypertension, smoking, IUGR.

Making Diagnosis

Clinical Features

• Presence of meconium-stained liquor during ROM or at birth → green/yellow amniotic fluid.
• Green staining of the infant’s skin, nail beds, or umbilical cord.
• Signs of respiratory distress → increased RR, grunting, cyanosis, noisy breathing, use of accessory muscles.
• Low APGAR score.
• Crackles on auscultation of fetal lungs.

<aside> 💡 Meconium-Stained Liquour + Respiratory Distress → Meconium Aspiration Syndrome

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Investigations

• CXR → overinflated lungs, patches of collapse and consolidation.

Management Plan

• Gentle suctioning of the mouth and nose to remove any visible residual meconium.
• Antibiotics → reduce risk of infection. IV gentamicin and ampicillin.