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Meconium Aspiration Syndrome

1. Meconium aspiration syndrome occurs when a newborn breathes meconium into their lungs before or during birth, causing respiratory distress. Risk factors include fetal stress, difficult delivery, advanced gestational age, and maternal health issues. 2. Symptoms include meconium in the amniotic fluid, discolored skin, breathing problems, and low Apgar scores. Diagnosis involves history, exam, and chest x-rays. Treatment focuses on respiratory support, surfactant therapy, and general care like monitoring and IV fluids. 3. Complications can include pneumonia, brain damage, and persistent pulmonary hypertension. Prevention centers on risk factor identification and immediate interventions during delivery like suctioning

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3K views

Meconium Aspiration Syndrome

1. Meconium aspiration syndrome occurs when a newborn breathes meconium into their lungs before or during birth, causing respiratory distress. Risk factors include fetal stress, difficult delivery, advanced gestational age, and maternal health issues. 2. Symptoms include meconium in the amniotic fluid, discolored skin, breathing problems, and low Apgar scores. Diagnosis involves history, exam, and chest x-rays. Treatment focuses on respiratory support, surfactant therapy, and general care like monitoring and IV fluids. 3. Complications can include pneumonia, brain damage, and persistent pulmonary hypertension. Prevention centers on risk factor identification and immediate interventions during delivery like suctioning

Uploaded by

JOSLIN
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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MECONIUM ASPIRATION SYNDROME

DEFINITION

Meconium aspiration syndrome Is respiratory distress in a newborn who has


breathed (aspirated) meconium into the lungs before or around the time of
birth.
ETIOLOGY AND RISK FACTORS
• Fetal stress
Additional risk factors for MAS include:
• A Difficult Delivery
• Advanced gestational age (or postmaturity)
Etiology contd….
• A mother who smokes cigarettes heavily or
has diabetes, hypertension or chronic
respiratory or cardiovascular disease
• Umbilical Cord Complications
• Poor intrauterine growth
Pathophysiology
CLINICAL FEATURES
• Meconium or dark green streaks or stains in the amniotic fluid
• Discoloration of the baby's skin — either blue (cyanosis) or
green (from being stained by the meconium)
• Problems with breathing —tachypnea, labored breathing, or
apnea
• Bradycardia in the baby before birth
CLINICAL FEATURES
Contd………….
• Low Apgar score
• Limpness in the baby (An irregular, jerky,
or awkward gait; a claudication)
Diagnostic measures

History

Physical Examination

Acid-base status-Metabolic acidosis

Chest radiography
TREATMENT

• The delivering obstetrician or midwife


should suction the newborn's mouth as
soon as the head emerges during delivery
• Respiratory care
• General supportive care
Respiratory care
• Oxygen administration
• Nasal CPAP
• Intubation and positive pressure ventilation
• SurfactantTherapy
• Suctioning
Surfactant therapy

Pulmonary surfactant is a mixture of lipids and proteins which is secreted into the alveolar
space by epithelial type II cells. The main function of surfactant is to lower the surface
tension at the air/liquid interface within the alveoli of the lung.
Surfactant therapy contd….
• Surfactant is delivered using an artificial
airway or breathing tube that is inserted into
the trachea, or windpipe,
• One or two doses at 100mg/kg
MONITORING DURING SURFACTANT THERAPY

Equipment needed
• Syringe containing the ordered dose of surfactant,
warmed to room temperature
• 5-Fr feeding tube or catheter, or endotracheal tube
connector with delivery port
• Mechanical ventilator or manual ventilator
(resuscitation bag)
CONTD……………..
Resuscitation equipment

Laryngoscope and endotracheal tube

Manual resuscitation bag and airway manometer

Blended oxygen source


Suction equipment (ie, catheters, sterile gloves, collecting bottle and tubing, and
vacuum generator)

Radiant warmer ready for use


CONTD………………….
Monitoring equipment
•  Neonatal tidal volume monitor if available
•  Airway pressure monitor
• Pulse oximeter or transcutaneous PCO2 monitor
•  Cardiorespiratory monitor
2.General supportive care
• Cardiovascular Support —
• Fluid restriction
• Antibiotic therapy — should be continued
until primary bacterial infection is excluded
• IV therapy and nil orally until the respiratory
distress is resolving
Possible Complications
• Aspiration pneumonia
• Brain damage
• Breathing difficulty that lasts for several days
• Collapsed lung (pneumothorax)
• Persistent pulmonary hypertension of the
newborn
Prevention
• Risk factors should be identified as early as
possible.
• Check whether the fluid was clear or stained
with a greenish or brown substance.
• Fetal monitoring
• Immediate intervention in the delivery room
Nursing Management
• During Delivery
• During labor, continuously monitor the fetus
• Immediately inspect any fluid passed with rupture of
the membrane.
• Assist with immediate endotracheal suctioning before
the first breaths, as indicated.
• Monitor lung status closely, including breath sounds
and respiratory rate and character
NICU Care

• Frequently assess the neonate’s vital signs.


• Administer treatment modalities, such as
oxygen and respiratory support as ordered.
• Institute measures to maintain a neutral
thermal environment.
Emotional support
• Proper explanation to the family members and ensure their
co-operation
• Assess the parent’s knowledge about the condition. Clarify
their doubts.
• Update the family frequently about the infant’s condition and
progress.
• Encourage family members to visit the child
• Emphasize positive aspects of the child
Emotional support contd…..
• Teach the family members how to handle the infant.
Encourage them to touch, cuddle etc
• Help the family members to feed the infant as
appropriate.
• Observe for persistent signs of lack of attachment
such as emotional withdrawal from the infant,
resistance to infant care, or fear of infant to taking to
home
• Give discharge advices and follow up timings
Prognosis
• Meconium aspiration syndrome is a leading cause of
severe illness and death in newborns.
• In most cases, the outlook is excellent and there are
no long-term health effects.
• Lack of oxygen before birth, or from complications
of meconium aspiration, may lead to brain damage.
• Meconium aspiration rarely leads to permanent lung
damage.
NURSING DIAGNOSIS ACCORDING TO PRIORITY

Impaired Ineffective Parental anxiety


breathing related to lack of
airway clearance
awareness about
pattern related related to
child’s disease
to obstruction presence of
condition,
of airway tract meconium plugs treatment, and
with meconium in the airway prognosis.
Nsg diagnosis CONTD………………..

Risk for hypothermia related to Risk for complication related to


immature thermoregulation administration of surfactants
Apnea
Pulmonary hemorrhage
Mucus plugs

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