Important information for parents whose newborn suffered a birth injury known as meconium aspiration syndrome
Meconium aspiration syndrome (MAS) can happen when a baby breathes in a mix of amniotic fluid and their first bowel movement (known as “meconium”) during either labor or delivery. If a baby can’t get the proper amount of oxygen, it can possibly lead to a serious birth injury with life-threatening consequences.
Up to 25 percent of all births after 34 weeks involve meconium in the amniotic fluid, and 10 percent of infants with amniotic fluid that has been meconium-stained will get MAS.
What Is Meconium?
Meconium is dark green fecal matter found in the intestines of a fetus, which infants pass during their first few days of life. Under normal circumstances, meconium is not passed from the baby’s body until soon after birth. In some cases, however, fetal distress during labor may cause the infant to pass meconium stools into the amniotic fluid while still inside the uterus.
After meconium gets into the amniotic fluid, the infant may breathe it into the lungs. This can cause a condition known as meconium aspiration syndrome (MAS), in which the newborn infant experiences breathing problems. MAS can have serious and potentially life-threatening complications.
Long-term MAS effects
Most meconium aspiration syndrome cases leave no lingering side effects and resolve relatively quickly. Rapid breathing often associated with MAS can last for several days, and will require careful monitoring from your medical team. In the most severe cases, possible meconium aspiration long term effects include:
- Mental retardation
- Central nervous system issues
- Permanent lung damage
Meconium aspiration death is possible. About half of all infants with severe cases are at risk of developing a narrowing of the airways. Because this risk is relatively high, delivery professionals should monitor your baby very carefully if they show signs of MAS.
Common signs and symptoms of MAS
Some of the most common symptoms and signs of meconium aspiration syndrome include:
- Low APGAR scores
- Bluish skin tone
- Difficulty breathing or not breathing at delivery
- Brown or dark green amniotic fluid
- Vocal cord staining as seen with a laryngoscope
- Coarse, crackly breathing
- Patchy, streaky areas of the lungs seen on X-ray
- Blood tests indicating a lack of oxygen
- Slow heart rate
- Persistent pulmonary hypertension
- Barrel-shaped chest
When a baby has passed their due date, they are more likely to have meconium before birth. There is less amniotic fluid after the due date, making any meconium passed less diluted and more likely to become congested in the lungs. The placenta may also have inefficiencies, decreasing the amount of oxygen the baby receives.
Causes of Meconium Aspiration
Stress during labor can cause increased movement of the infant’s intestines and relaxation of the sphincter muscle, which allows meconium to pass into the amniotic fluid. Fetal stress during labor can result from:
- Decreased oxygen supply to the infant in the uterus
- Pregnancy that goes beyond the due date (more than 40 weeks)
- A long or difficult labor
- High blood pressure or diabetes in the mother
Treatment options for MAS
When babies have healthy vitals and otherwise seem unaffected, they have a good prognosis. Further action might not be necessary in such cases. However, the medical team should monitor your baby closely and address any complications that arise.
There are several steps that doctors can take for meconium aspiration treatment. Doctors can insert a tube into the windpipe to suction out meconium, as well as tapping on the baby’s chest to loosen any secretions. Antibiotics might be necessary to combat infection and increase the chances of a successful recovery.
Other measures might include a respirator for better breathing or a warmer for a more consistent body temperature. Medical professionals might administer oxygen or transfer the baby to the intensive care unit for newborns (NICU). Additional measures include ECMO (which is a heart and lung bypass procedure), nitric oxide for better oxygen flow and administering surfactant (which helps the lungs function better).
A mother delivering a baby at risk for MAS would benefit from delivering in a setting where the delivery team is trained in emergency resuscitation. Professionals with this type of training know how to restore a baby’s breathing and heartbeat if necessary. Fast action can make all the difference between life or death for babies in this situation.
Emergency Treatment for Meconium Aspiration
When MAS has occurred, the infant will need emergency medical treatment immediately after birth. The doctor will first suction the baby’s nose, mouth, and throat. Then a tube is placed in the newborn’s trachea to suction out the fluid containing meconium. Suction is continued until no more meconium can be seen in the fluid removed from the baby’s windpipe.
If the heart rate is low or the infant is not breathing, the doctor will use a mask and bag to help the child breathe, deliver oxygen, and inflate the lungs. A breathing tube may be needed for a child who is not breathing on his own, or for one who is seriously ill. After emergency treatment, the infant may be placed in a special care unit for additional treatment and observation.
When doctor negligence plays a role
Though not always the case, doctor negligence can be responsible for MAS and complications of the syndrome. For example, a doctor might notice discoloration in the amniotic fluid that indicates a problem. Gestational diabetes or high blood pressure during pregnancy that go without being addressed properly can be contributing factors, as well as poorly-managed emergency resuscitation techniques.
Having a pregnancy going past its due date or a difficult delivery can also play a role in MAS. Many of these types of issues go without proper treatment, increasing the risk of complications. Passing meconium in the womb or during delivery is more likely to happen because of distress.
Resuscitation attempts performed improperly can also contribute to complications from MAS. For instance, inserting a breathing tube improperly or delaying treatment can be responsible for these types of complications. Time matters in the case of an infant in distress for better odds of survival and a decreased risk of serious complications like MAS.
Complications of Meconium Aspiration Syndrome
Many newborns with mild MAS are able to recover with no long-term health consequences, while others are not as fortunate. Meconium aspiration is a serious matter that can lead to:
- PPHN: Persistent pulmonary hypertension is a life-threatening condition in which blood flow is restricted by high blood pressure in the lungs’ vessels, making it difficult for the child to breathe properly.
- Brain damage: Although the occurrence is rare, severe MAS can limit the supply of oxygen to the brain, causing permanent brain damage to the child.
When to contact a birth injury attorney
Both the legal and medical aspects of a birth injury case may seem overwhelming. Caring for a child with a birth injury requires a lot of resources, financially or otherwise. Brown Trial Firm is ready to help you with your case from our offices in Houston and Waco.
Physicians can help prevent MAS by monitoring the health of the fetus and the condition of the placenta before the delivery. Once MAS has occurred, it is vital that medical professionals act swiftly to provide effective emergency medical treatment, so the child’s brain is not deprived of oxygen. If your baby suffered meconium aspiration syndrome and you believe your health care providers were negligent in managing the situation, call us today at +1 (866) 393-2611. Birth injury lawyer Laura Brown will be happy to meet with you in a free case consultation and advise you of your options under the law.
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