Meconium aspiration

Question 1

What is meconium aspiration? (RF and Sx)

Answer 1

Resp distress in newborn due to meconium in the trachea
8-20% will pass meconium before birth -> chance of aspiration
rare in preterm, INCREASED RISK WITH GESTTATIONAL AGE

RF -
GA>42weeks, mum substance abuse
Fetal distress/hypoxia, oligohydroamnios, meconium stained amniotic fluid, chorioamniotis

Sx
Resp distress at birth - increased RR, chest retraction/costal, hypoxia, blue etc

Question 2

Ix and Mx of meconium aspiration

Answer 2

CXR is diagnostic and 1st line in distressed children - overinflated lungs, patches of collapse and consolidation
can see pneumothorax (air leak), pneumomediastinum
FBC. CRP, culture -2nd ary infection common

Mx -
observation -normal term with RF (meconium stain fluid) but no hx of GBS
IV amp and IV gent -features of Infection
O2 and NIV -severe not improving

Question 3

what is meconium ileus

Answer 3

thick sticky meconium that has prolonged passsing time -
normally within 24h -meconium ileus is SLOWER
can occasionaly vomit it isntead of passing it

Associated with cystic fibrosis and biliary atresia

Mx -
1st line -gastrograffin enema
2nd -surgery