Oxidative stress results in vasoconstrictionbronchoconstrictionplatelet aggregation and accelerated cellular apoptosis. The presence of fetal intestinal enzymes have been found in the amniotic fluid of women who are as early as 14—22 weeks pregnant.
Other treatments may include: These indicate a direct detrimental effect on lung alveolar cells because of the introduction of meconium into the lungs. Then, because of intrauterine gasping or from the first few breaths after delivery, MAS may develop.
MIAC is associated with high concentrations of cytokines such as IL-6chemokines such as IL-8 and monocyte chemoattractant protein-1complementphospholipase A2 and matrix-degrading enzymes.
If the baby is active and crying, no treatment is needed.
Resuscitation should follow the same principles for infants with meconium-stained fluid as for those with clear fluid. As meconium is stored inside the intestinesand is partly unexposed to the immune systemwhen it becomes aspirated the innate immune system recognises as a foreign and dangerous substance.
Retrieved 17 April However, meconium-stained amniotic fluid is a condition that requires the notification and availability of an appropriately credentialed team with full resuscitation skills, including endotracheal intubation. Complications Infant respiratory distress syndrome Respiratory distress that usually occurs within four hours of birth and becomes persistently worse for Meconium stained amniotic fluid thesis to 72 hours is known as infant respiratory distress syndrome.
Outlook Prognosis In most cases of meconium-stained fluid, the outlook is excellent and there are no long-term health effects. The information should not be construed as dictating an exclusive course of treatment or procedure to be followed.
Assisted Ventilation Techniques[ edit ] To clear the airways of meconium, tracheal suctioning can be used however, the efficacy of this method is in question and it can cause harm.
Observations include monitoring heart raterespiratory rateoxygen saturation and blood glucose to detect worsening respiratory acidosis or the development of hypoglycemia. It is common for sedation and muscle relaxants to be used to optimise ventilation and minimise the risk of pneumothorax associated with dyssynchronous breathing.
Meconium induces an inflammatory reaction within the lungs as there is an increase of autophagocytic cells and levels of caspase 3 after exposure. Inthe guidelines were updated to reflect new evidence in the management of nonvigorous newborns with meconium-stained fluid.
If the infant is vigorous with good respiratory effort and muscle tone, the infant may stay with the mother to receive the initial steps of newborn care. This Meconium stained amniotic fluid thesis called persistent pulmonary hypertension of the newborn PPHN.
The Committee on Obstetric Practice agrees with the recommendation of the American Academy of Pediatrics and the American Heart Association that infants with meconium-stained amniotic fluid, regardless of whether they are vigorous or not, should no longer routinely receive intrapartum suctioning.
Some newborns with MAS can have homogenous lung changes and others can have inconsistent and patchy changes to their lungs.
Meconium can be analyzed to detect the tobacco use of mothers during their pregnancy, which is commonly under-reported. Sometimes it is hard to diagnose MAS as it can be confused with other diseases that also cause respiratory distress, such as pneumonia.
Appropriate intervention to support ventilation and oxygenation should be initiated as indicated for each infant and, if the airway is obstructed, this may include intubation and suction. The severity of respiratory distress can vary significantly between newborns with MAS, as some require minimal or no supplemental oxygen requirement and, in severe cases, mechanical ventilation may be needed.
A deficiency of surfactant produces high alveolar surface tension. After 60 minutes of exposure, the meconium travels further down into the smaller airways.
Surfactant to help lungs exchange oxygen. Meconium ileus[ edit ] The meconium sometimes becomes thickened and congested in the intestinesa condition known as meconium ileus. Thus, every breath takes a lot of effort for relatively poor expansion.
Gentle clearing of meconium from the mouth and nose with a bulb syringe may be done if necessary. Before the guidelines, management of a newborn with meconium-stained amniotic fluid included suctioning of the oropharynx and nasopharynx on the perineum after the delivery of the head but before the delivery of the shoulders.
Surfactant replacement therapy has shortened the duration of the disease and significantly reduced mortality. Additionally, newborns with MAS can have other types of respiratory distress such as tachypnea and hypercapnia. If the baby is not active and crying right after delivery, the team will: Above the level of the obstruction, there are several loops of hypertrophied bowel distended with fluid.
Pediatrics ; suppl 2: Your provider will want to be prepared for meconium being present at birth if: Review provided by VeriMed Healthcare Network. In addition, meconium-stained amniotic fluid is a condition that requires the notification and availability of an appropriately credentialed team with full resuscitation skills, including endotracheal intubation.
Similarly, intestinal parasympathetic innervation and myelination also increases in later gestations. There should be no suction prior to delivery.Meconium Stained Amniotic Fluid, Pediatrics Point of View, Respiratory Disorder, Meconium Aspiration Syndrome, Obstruction of Airway, Pneumonitis, Pulmonary Vasoconstriction.
This lecture is very interesting and contains useful information about above mentioned topics of Neonatology. List of Thesis and Dissertation topics for Neonatology. COMPARATIVE STUDY OF NUCLEATED RED BLOOD CELLS IN CORD BLOOD OF NEONATES WITH MECONIUM STAINED AMNIOTIC FLUID AND CLEAR AMNIOTIC FLUIDS.
M, Babu: List of thesis and dissertation topics for Pediatric MD and Neonatologist. Meconium-stained amniotic fluid is really worrisome from both the obstetrician's and the paediatrician's point of view, as it increases the caesarean rates, and causes birth asphyxia, MAS and an increase in neonatal intensive care unit admissions.
An abnormal heart rate predicts fetal distress much more accurately than MSAF (Meconium Stained Amniotic Fluid); and an abnormal heart rate along with meconium in the water may be an even better indication that a baby may be in trouble.
Oct 16, · Obstetrics & Gynecology Thesis Topics.
Posted by Doctors Hangout on October 16, at am in Thesis; Transcervical Amnio Infusion in Labour for Meconium Stained Amniotic Fluid - Its effects on Feto-Maternal Outcome, Sepsis Screening in the Newborn: OBSTETRICS & GYNECOLOGY.
Terminal meconium. Most of the time that the amniotic fluid is stained with meconium it will be homogeneously distributed throughout the fluid making it brown.Download