Meconium stained amniotic fluid: Antenatal, intrapartum, postnatal management:review [Mekonyum Boyal Amniyotik Sv: Antenatal, ntrapartum, Postnatal Yönetim]

Abstract

Approximately 13o of all live births are complicated by meconium stained amniotic fluid and only 5o of neonates born through of them develop meconium aspiration syndrome (MAS). In case of meconium stained amniotic fluid and respiratory distress MAS should be ruled out. Meconium aspiration may occur in utero or in first a few inspirations. Chronic fetal hypoxia and acidosis may cause fetal gasping and meconium aspiration in utero. Respiratory distress may ta ke place by the aspiration of meconium stained amniotic fluid in the nasopharynx of normal new born. Severity criteria for MAS are also defined. Mild MAS is a disease that requires less than 40o oxygen for less than 48 hours, moderate MAS is disease that requires more than 40o oxygen for mo re than 48 hours with no air leak, and severe MAS is a disease that requires assisted ventilation for more than 48 hours and is often associated with persistent pulmonary hypertension. The principal of prenatal management is to consider mecoium stained amniotic fluid as a sign of fetal distress and to follow closely the other signs of fetal distress. Intrapartum suctioning is not very effective and if the infant is vigorous defined as strong respiratory efforts, good muscle tone and a heart rate grea ter than 100 bpm, intubation and tracheal aspiration is not necessary. Pharmacotherapy of MAS in dude sedation and analgesia, pulmonary care, antibiotics, anti inflammatory agents and pulmonary vasodilators, surfactant and surfactant lavage. Copyright © 2012 by Türki ye Klinikleri