Document Detail

Meconium aspiration syndrome: pathophysiology and prevention.
MedLine Citation:
PMID:  10612363     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Despite the common occurrence of intrauterine meconium passage and resultant meconium aspiration syndrome (MAS), controversies regarding the pathophysiology and use of appropriate preventive strategies abound. METHODS: Databases from MEDLINE, MD Consult, and the Science Citation Index were searched from 1964 to the present to find relevant sources of information. RESULTS AND CONCLUSIONS: Meconium passage occurs by three distinct mechanisms: (1) as a physiologic maturational event, (2) as a response to acute hypoxic events, and (3) as a response to chronic intrauterine hypoxia. Meconium passage might merely be a marker of chronic intrauterine hypoxia or can predispose to aspiration of meconium and resultant inflammatory pneumonitis, surfactant inactivation, and mechanical airway obstruction. Aspiration can occur in utero with fetal gasping, or after birth with the first breaths of life. Many cases of MAS can be prevented by the strategies addressed in this article, but some will occur despite appropriate preventive techniques. There is not enough evidence to support the use of amnioinfusion as a standard of care for all pregnancies complicated by meconium. Pharyngeal suctioning before delivery of the shoulders is an effective preventive intervention, as is the combination of pharyngeal suctioning followed by intubation and tracheal suctioning. Suctioning of the trachea may be done on a selective basis depending on fetal vigor and consistency of meconium.
M C Klingner; J Kruse
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The Journal of the American Board of Family Practice / American Board of Family Practice     Volume:  12     ISSN:  0893-8652     ISO Abbreviation:  J Am Board Fam Pract     Publication Date:    1999 Nov-Dec
Date Detail:
Created Date:  2000-01-18     Completed Date:  2000-01-18     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  8807505     Medline TA:  J Am Board Fam Pract     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  450-66     Citation Subset:  IM    
Department of Family and Community Medicine, Southern Illinois University School of Medicine, Quincy Family Practice Program, USA.
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MeSH Terms
Infant, Newborn
Meconium Aspiration Syndrome / complications,  physiopathology*,  prevention & control
Persistent Fetal Circulation Syndrome / etiology
Pneumonia / etiology,  pathology
Pneumothorax / etiology
Pulmonary Surfactants
Risk Factors
Reg. No./Substance:
0/Pulmonary Surfactants

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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