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About Meconium Aspiration (MAS) – Part 1

• MAS can happen before, during, or after labor.
• It can happen even after delivery when a newborn inhales (or aspirates) a mixture of meconium and amniotic fluid.
• Meconium is the baby’s first feces, or poop.
• This is sticky, thick, and dark green substance.
• It is typically passed in the womb during early pregnancy and again in the first few days after birth.
• The inhaled meconium can partially or completely block the baby’s airways.
• The meconium becomes trapped in the airways when the baby breathes out.
• The inhaled meconium irritates the baby’s airways and makes it difficult to breathe.
• MAS can affect the baby’s breathing in a number of ways.

This includes:
• Chemical irritation to the lung tissue.
• Airway obstruction by a meconium plug.
• Infection.
• The inactivation of surfactant by the meconium.

The severity of MAS depends on the amount of meconium the baby inhales as well as underlying conditions.
• The conditions can be infections within the uterus or post maturity
• The more meconium a baby inhales, the more serious the condition.
• The fluid is moved in and out of only the trachea when there’s breathing activity in the fetus
• Meconium can be inhaled into the lungs when the baby gasps while still in the womb
• This can be during the initial gasping breaths after delivery
• This gasping typically happens when there has been a problem
• This is like an infection or compression of the umbilical cord that causes the baby to have difficulty getting enough oxygen in the womb


• Not all infants who pass meconium during labor and delivery develop MAS
• Of the babies who either pass meconium during birth or are delivered having meconium-stained fluid, 2% to 36% either inhale the meconium in uteri or with the first breath
• Of the infants born with meconium-stained amniotic fluid, 11% of them experience some degree of MAS.

Causes of Meconium Aspiration

• MAS is often related to fetal stress.
• Fetal stress can be caused by problems in the womb, such as infections, or by difficulties during the labor process.
• A distressed baby may experience hypoxia (decreased oxygen), which may make the baby’s intestinal activity increase.
• This may cause relaxation of the anal sphincter.
• This relaxation then moves meconium into the amniotic fluid that envelops the baby.
• But meconium passage during labor and delivery isn’t always associated with fetal distress.
• Babies who aren’t distressed during the birth process pass meconium before birth.
• In either case, a baby that gasps or inhales meconium can develop MAS.

Risk Factors for Meconium Aspiration

• Mother who had a difficult delivery.
• Mothers with advanced gestational age (or postmaturity).
• A mother who smokes heavily.
• Mother who has special conditions like diabetes, high blood pressure (hypertension), or chronic respiratory or cardiovascular disease.
• Deliveries with umbilical cord complications.
• Cases of poor intrauterine growth.

Nursing Diagnosis Handbook The Birth Partner, Third Edition Meconium Aspiration Syndrome

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