Abstract
Meconium aspiration syndrome can present clinically with different degrees of severity,
ranging from a mild form of respiratory compromise to severe forms that may result
in perinatal death despite mechanical ventilation or extracorporeal membrane oxygenation.
However, advances in our knowledge concerning meconium aspiration syndrome have revealed
that most cases of severe meconium aspiration syndrome are not in fact causally related
to the aspiration of meconium but rather are caused by other pathologic processes
occurring in utero, primarily chronic asphyxia and infection. Proper understanding
of the causative processes underlying fetal or neonatal compromise in these cases
is essential to direct future research into preventive or therapeutic treatments and
for counseling of the parents of an affected child. (Am J Obstet Gynecol 2001;185:931-8.)
Keywords
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References
- Meconium staining and the meconium aspiration syndrome.Pediatr Clin North Am. 1993; 40: 955-981
- Meconium aspiration in infants: a prospective study.J Pediatr. 1974; 85: 848-852
- Tracheal suction in meconium aspiration.Am J Obstet Gynecol. 1975; 122: 767-771
- Combined obstetric and pediatric approach to prevent meconium aspiration syndrome.Am J Obstet Gynecol. 1976; 126: 712-715
- Fatal meconium aspiration syndrome occurring despite airway management considered appropriate.Am J Obstet Gynecol. 1985; 151: 731-736
- In utero meconium aspiration: an unpreventable cause of neonatal death.Br J Obstet Gynaecol. 1987; 94: 813-814
- Failure to prevent meconium aspiration syndrome.Obstet Gynecol. 1988; 71: 349-353
- Prophylactic amnioinfusion during labor complicated by meconium: a preliminary report.Am J Obstet Gynecol. 1989; 163: 613-617
- Does DeLee suction at the perineum prevent meconium aspiration syndrome?.Am J Obstet Gynecol. 1992; 167: 1243-1249
- Meconium aspiration syndrome: reflections on a murky subject.Am J Obstet Gynecol. 1992; 166: 171-183
- Meconium-stained amniotic fluid and the meconium aspiration syndrome.Pediatr Clin N Am. 1998; 45: 511-529
- Criteria for evaluating evidence regarding the effectiveness of prenatal interventions.in: New perspectives on prenatal care. Elsevier, New York1990: 31-38
- The pulmonary vasculature in meconium aspiration.Hum Pathol. 1989; 20: 701-706
- Prediction of the severity of meconium aspiration syndrome.Am J Obstet Gynecol. 1993; 169: 61-70
- Fatal meconium aspiration in spite of appropriate perinatal airway management: pulmonary and placental evidence of prenatal disease.Am J Obstet Gynecol. 1997; 176: 967-975
- Association of elective repeat cesarean delivery and persistent pulmonary hypertension of the newborn.Am J Obstet Gynecol. 1985; 152: 627-629
- Treatment of persistent pulmonary hypertension of the newborn: update.Arch Dis Child. 1991; 66: 74-82
- Persistent fetal circulation: newly recognized structural features.J Pediatr. 1976; 88: 614-620
- Pulmonary vascular disease in fatal meconium aspiration.J Pediatr. 1984; 104: 158-162
- Structure and function of the pulmonary vascular bed: an update.Cardiol Clin. 1989; 7: 227-238
- Failure of acute perinatal asphyxia or meconium aspiration to produce persistent pulmonary hypertension in a neonatal baboon model.Am J Obstet Gynecol. 1994; 171: 43-49
- Meconium-induced lung injury mediated by activation of alveolar macrophages.Life Sci. 1994; 54: 1559-1562
- Meconium increases surfactant secretion in isolated rat alveolar type II cells.Pediatr Res. 1996; 39: 443-447
- Meconium decreases surfactant protein B levels in rat fetal lung explants.Pediatr Res. 1997; 41: 137A
- Management of a piglet model of the meconium aspiration syndrome with high-frequency or conventional ventilation.Am J Dis Child. 1992; 146: 1287-1293
- Liquid assisted ventilation: an alternative ventilatory strategy for acute meconium aspiration injury.Pediatr Pulmonol. 1996; 21: 316-322
- Use of intratracheal pulmonary ventilation versus conventional ventilation in meconium aspiration syndrome in a newborn pig model.Crit Care Med. 1997; 25: 1947-1948
- Experimental meconium aspiration in guinea pigs.Obstet Gynecol. 1989; 73: 652-656
- Effect of nitric oxide in meconium aspiration syndrome after treatment with surfactant.Crit Care Med. 1997; 25: 1744-1747
- Bronchoalveolar lavage with KL4-surfactant in models of meconium aspiration syndrome.Pediatr Res. 1998; 44: 705-715
- Meconium aspiration syndrome: physiological and inflammatory changes in a newborn piglet model.Pediatr Pulmonol. 1993; 16: 101-108
- Meconium aspiration syndrome: intrapartum and neonatal attributes.Am J Obstet Gynecol. 1989; 161: 1106-1110
- The impact of a policy of amnioinfusion for meconium-stained amniotic fluid.Obstet Gynecol. 1995; 85: 237-241
- Accuracy of admission chest x-ray in the prediction of sickness severity in infants with meconium aspiration syndrome [abstract].Clin Res. 1993; 41: 736
- Meconium aspiration syndrome: have we made a difference?.Pediatrics. 1990; 85: 715-721
- The failure of routine amnioinfusion in patients with thick meconium to eliminate the occurrence of meconium aspiration syndrome [abstract].Am J Obstet Gynecol. 1992; 166: 405
- Prophylactic amnioinfusion for meconium-stained amniotic fluid.Am J Obstet Gynecol. 1994; 171: 931-935
- Intrapartum fetal heart rate monitoring. III. Association of meconium with abnormal fetal heart rate patterns.Am J Obstet Gynecol. 1980; 137: 936-942
- Fatal meconium aspiration “in utero”: a case report.Am J Obstet Gynecol. 1978; 132: 111-113
- Meconium below the vocal cords at delivery: correlation with intrapartum events.Am J Obstet Gynecol. 1985; 153: 767-770
- Meconium aspiration syndrome without evidence of fetal distress in early labor before elective cesarean section.Obstet Gynecol. 1989; 73: 707-709
- Possible causes linking asphyxia, thick meconium, and respiratory distress.Aust N Z J Obstet Gynaecol. 1991; 31: 97-102
- The prevention of meconium aspiration in labor using amnioinfusion.Obstet Gynecol. 1989; 73: 647-651
- Prophylactic amnioinfusion improves outcome of pregnancy complicated by thick meconium and oligohydramnios.Am J Obstet Gynecol. 1992; 167: 117-121
- Intrauterine meconium aspiration.Obstet Gynecol. 1981; 57: 26-29
- In utero distal pulmonary meconium aspiration.South Med J. 1979; 72: 535-536
- Outcomes of post-term births: the role of fetal growth restriction and malformations.Obstet Gynecol. 1999; 94: 758-762
- Pregnancies complicated by idiopathic intrauterine growth retardation.J Reprod Med. 1995; 40: 209-215
- Histologic evidence of old intrauterine bleeding is more frequent in prematurity.Am J Obstet Gynecol. 1995; 173: 1065-1070
- Mouse ATF-2 null mutants display features of a severe type of meconium aspiration syndrome.J Biol Chem. 1999; 274: 17813-17819
- Meconium passage: a new classification for risk assessment during labor.Am J Obstet Gynecol. 1978; 131: 509-513
- Intratracheal suctioning, systemic infection, and the meconium aspiration syndrome.Pediatrics. 1992; 89: 203-206
- Meconium-stained amniotic fluid: a risk factor for microbial invasion of the amniotic cavity.Am J Obstet Gynecol. 1991; 164: 859-862
- Maternal and perinatal outcome of patients with preterm labor and meconium-stained amniotic fluid.Obstet Gynecol. 1995; 86: 830-833
- The prevalence and distribution of acute placental inflammation in uncomplicated term pregnancies.Obstet Gynecol. 1989; 73: 383-389
- Fetal tachycardia as an indicator of maternal and neonatal morbidity.Obstet Gynecol. 1985; 66: 191-194
- Second stage fetal heart rate abnormalities and type of neonatal acidemia.Obstet Gynecol. 1987; 70: 191-195
- Effect of interleukin-8 in meconium on in-vitro neutrophil chemotaxis.Lancet. 1998; 352: 102-105
- Inhibition of neutrophil oxidative burst and phagocytosis by meconium.Am J Obstet Gynecol. 1995; 173: 1301-1305
- Meconium-stained amniotic fluid-associated infectious morbidity: a randomized, double-blind trial of ampicillin-sulbactam prophylaxis.Obstet Gynecol. 1996; 88: 216-220
- An experimental model for the study of meconium aspiration of the newborn.Pediatr Radiol. 1971; 100: 137-140
- In utero meconium aspiration in the baboon fetus.Obstet Gynecol. 1981; 57: 37-40
- Changes in lung liquid dynamics induced by prolonged fetal hypoxemia.J Appl Physiol. 1990; 69: 127-135
- Meconium aspiration and fetal acidosis.Obstet Gynecol. 1985; 65: 352-355
- Postasphyxial lung disease in newborn infants with severe perinatal acidosis.Am J Obstet Gynecol. 1984; 150: 393-399
- Meconium in the amniotic fluid and fetal acid-base status.Obstet Gynecol. 1989; 73: 175-178
- Early clinical findings in infants born with meconium stained amniotic fluid.Pediatr Res. 1989; 25: 356A
Article info
Footnotes
*Reprint requests: Alessandro Ghidini, MD, Department of Obstetrics and Gynecology, Georgetown University Hospital, 3800 Reservoir Rd, NW, 3PHC, Washington, DC 20007. E-mail: [email protected]
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© 2001 Published by Elsevier Inc.
