eMedicine Specialties > Pediatrics: Cardiac Disease and Critical Care Medicine > Neonatology

Meconium Aspiration Syndrome: Follow-up

Author: Melinda B Clark, MD, Assistant Professor of Pediatrics, Department of Pediatrics, Albany Medical College
Coauthor(s): David A Clark, MD, Chairman, Professor, Department of Pediatrics, Albany Medical College
Contributor Information and Disclosures

Updated: Dec 2, 2008

Follow-up

Further Inpatient Care

  • In patients with meconium aspiration syndrome (MAS), thorough cardiac examination and echocardiography are necessary to evaluate for congenital heart disease and persistent pulmonary hypertension of the newborn (PPHN).
  • Confirming the degree of pulmonary hypertension, prior to instituting therapy, is extremely important.

Further Outpatient Care

  • Infants with meconium aspiration syndrome are at increased risk for adverse developmental outcomes and should be referred for developmental assessment as an outpatient.

Transfer

  • Although initial stabilization is necessary at community hospitals, infants with meconium aspiration syndrome frequently require high-frequency ventilation, inhaled nitric oxide (NO), or extracorporeal membrane oxygenation (ECMO). Therefore, in the event of significant aspiration, transferring these infants to a regional neonatal ICU (NICU) as soon as possible is important.

Complications

  • Children with meconium aspiration syndrome may develop chronic lung disease as a result of intense pulmonary intervention.
  • Infants with meconium aspiration syndrome have a slightly increased incidence of infections in the first year of life because the lungs are still in recovery.

Prognosis

  • Most infants with meconium aspiration syndrome have complete recovery of pulmonary function.
  • Intrapartum events initiating the meconium passage may cause the infant to have long-term neurologic deficits, including CNS damage, seizures, mental retardation, and cerebral palsy.

Miscellaneous

Medicolegal Pitfalls

  • Many infants who have experienced meconium aspiration syndrome (MAS) have had prenatal and postnatal periods of hypoxia and acidosis; therefore, these individuals are at increased risk of significant CNS damage.
  • Typically, medicolegal action is initiated by parents whose newborn develops long-term sequelae from significant perinatal hypoxia. Although the delivering physician is the primary focus of such a lawsuit, additional liability to other healthcare professionals may ensue from a poorly planned and executed resuscitation.
  • Commonly, the providers of the tertiary intensive care are included in these lawsuits, which are usually due to complications of necessary complex and aggressive care. Although other organ systems may be damaged by the initial insult and subsequent therapy, they are rarely the basis of legal action.
 


More on Meconium Aspiration Syndrome

Overview: Meconium Aspiration Syndrome
Differential Diagnoses & Workup: Meconium Aspiration Syndrome
Treatment & Medication: Meconium Aspiration Syndrome
Follow-up: Meconium Aspiration Syndrome
Multimedia: Meconium Aspiration Syndrome
References
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References

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Further Reading

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Keywords

meconium aspiration syndrome, MAS, meconium-stained amniotic fluid, fetal hypoxic distress, intrauterine distress, placental insufficiency, maternal hypertension, preeclampsia, oligohydramnios, maternal drug abuse, neonatal respiratory distress, airway obstruction, surfactant dysfunction, chemical pneumonitis, pulmonary hypertension, atelectasis, persistent pulmonary hypertension of the newborn, PPHN, pneumothorax, pneumomediastinum, pneumopericardium, pulmonary interstitial emphysema, respiratory acidosis, metabolic acidosis, syndrome of inappropriate secretion of antidiuretic hormone, SIADH

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Contributor Information and Disclosures

Author

Melinda B Clark, MD, Assistant Professor of Pediatrics, Department of Pediatrics, Albany Medical College
Melinda B Clark, MD is a member of the following medical societies: Alpha Omega Alpha, Ambulatory Pediatric Association, American Academy of Pediatrics, and Medical Society of the State of New York
Disclosure: Nothing to disclose.

Coauthor(s)

David A Clark, MD, Chairman, Professor, Department of Pediatrics, Albany Medical College
David A Clark, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, American Pediatric Society, Christian Medical & Dental Society, Medical Society of the State of New York, New York Academy of Sciences, and Society for Pediatric Research
Disclosure: Nothing to disclose.

Medical Editor

Steven M Donn, MD, Professor of Pediatrics, Director, Neonatal-Perinatal Medicine, Department of Pediatrics, University of Michigan Health System
Steven M Donn, MD is a member of the following medical societies: American Pediatric Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from broker recommendation; Avanir Pharma Stock Investment from broker recommendation

Managing Editor

Brian S Carter, MD, FAAP, Professor of Pediatrics (Neonatology), Vanderbilt University School of Medicine; Co-director, Pediatric Advance Comfort Team, Monroe Carell Jr Children's Hospital at Vanderbilt
Brian S Carter, MD, FAAP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, National Hospice and Palliative Care Organization, and National Perinatal Association
Disclosure: Nothing to disclose.

CME Editor

Carol L Wagner, MD, Professor of Pediatrics, Medical University of South Carolina
Carol L Wagner, MD is a member of the following medical societies: American Academy of Pediatrics, American Chemical Society, American Medical Women's Association, American Public Health Association, American Society for Bone and Mineral Research, American Society for Clinical Nutrition, Massachusetts Medical Society, National Perinatal Association, and Society for Pediatric Research
Disclosure: Nothing to disclose.

Chief Editor

Ted Rosenkrantz, MD, Professor, Departments of Pediatrics and Obstetrics/Gynecology, Division of Neonatal-Perinatal Medicine, University of Connecticut School of Medicine
Ted Rosenkrantz, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Pediatric Society, Connecticut State Medical Society, Eastern Society for Pediatric Research, and Society for Pediatric Research
Disclosure: Nothing to disclose.

 
 
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