Baby Inhaling Poop In The Womb – Health Complications of Meconium Aspiration Syndrome
Every prospective parent wishes for an uncomplicated birth and welcome a healthy baby to this world. Some baby passes the nine-month phase with ease, while some others frighten the people in the delivery room. One such complication that occurs just before the birth is meconium aspiration syndrome. Let’s go through this in detail.
Meconium aspiration syndrome
Meconium refers to the thick dark green fecal substance that is produced in your baby’s intestines during the end stage of pregnancy or just before birth. After the baby is delivered, he or she will pass this stool like material for a few days. However, some babies pass the meconium in the womb and before the delivery. It then mixes with amniotic fluid in the womb.
Then the baby may inhale this mixture of meconium and amniotic fluid into their lungs just shortly before or during the delivery. This is called as meconium aspiration syndrome or MAS. Though the condition is not fatal, severe cases or if left untreated, it can result in dangerous health complications for the newborn.
How common is meconium aspiration syndrome?
Prevalence of meconium-stained amniotic fluid (MSAF) occurs in 1 in 7 pregnancies. And out of these cases, about 5 percent of infants develop meconium aspiration syndrome. About half of the cases of meconium-stained amniotic fluid (MSAF) mostly occur in full-term pregnancies. The condition rarely occurs in preterm babies.
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What causes the baby to poop in the womb?
The condition occurs mainly when the baby experiences stress. If meconium is detected during labor and birth, you shall be closely monitored for fetal distress. The stress is often a result of lack of adequate oxygen (hypoxia). Some other common causes of fetal distress are:
- Overdue pregnancy that goes over 42 weeks or more
- Prolonged labor
- Health issues of the mother such as diabetes or high blood pressure
The growing baby does not produce meconium until the end stage of pregnancy. So when pregnancy due date passes, the baby has a risk of exposing to meconium.
Signs to watch for meconium aspiration syndrome
Respiratory distress is the classic symptom of meconium aspiration syndrome. Your baby would start breathing rapidly or grunt while breathing. The condition might stop the breathing of the newborn due to blockage of airways. Before delivery, it is impossible to tell whether the baby has inhaled meconium or not. Watch for following symptoms of MAS at birth:
- Bluish colour of the skin (cyanosis)
- No crying
- Lack of movement
- Low heart rate of the baby before birth
You don’t have to worry as the doctor and midwives would be watching closely for these signs.
How is meconium aspiration syndrome diagnosed?
As MAS occurs just before or during the delivery, you would be on close watch. The diagnoses can me simply made by checking the symptoms of newborn and presence of meconium in the amniotic fluid. Moreover, the doctor will use a stethoscope to listen to the abnormal breathing.
Doctors usually conduct following measures for detecting the condition:
Blood gas test – This test evaluates the levels of oxygen and carbon dioxide of the baby
Chest X-ray – The doctor would be performing a chest x-ray to check if the fecal material has entered the lungs of the baby
Complications of meconium aspiration – How it could prove life-threatening
Meconium aspiration does not pose any long-term health complications in most newborns. However, this is a severe issue that has to be taken into account without delay. It can immediately affect the health of your baby causing infection or inflammation in the lungs. Other complications arising from meconium aspiration include:
- Blockage of the airways which can cause the lungs to inflate too much. This can cause rupture.
- The air inside the lungs can build up inside the chest cavity and around the lung causing pneumothorax. This can create problems in re-inflating the lungs.
- Risk of baby developing persistent pulmonary hypertension of the newborn (PPHN). This condition hampers blood flow, making difficult for the baby to breathe. This is a rare but life-threatening condition.
- Reduced oxygen supply to brain which can cause permanent brain damage. However, this happens rarely.
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Treating meconium aspiration syndrome – Does the condition needs emergency treatment?
If the doctor confirms the diagnosis, the newborn baby would need treatment without delay. The treatment would be focused on removing the meconium content, especially from the upper airway.
For this, the doctor would suction the nose, mouth, and throat immediately after childbirth. If the baby isn’t breathing well, a tube might be placed in baby’s windpipe to suction the fecal material.
Use of bag and mask
For a newborn with low heart rate or not breathing properly, the doctor can use a bag and mask to help the baby breathe normally. This technique delivers oxygen and helps inflate the lungs of the newborn.
Soon after the above emergency treatment, the newborn might be closely monitored in a special neonatal care unit for breathing problems. Some additional treatment might be necessary to further avoid any complications. Depending on the case, these treatments would include:
- Oxygen therapy for ensuring enough supply of oxygen in the blood
- Antibiotics such as gentamicin and ampicillin to treat or prevent infection
- Radiant warmer to help the newborn maintain normal body temperature
- Ventilator to help the child breathe properly
- Extracorporeal membrane oxygenation (ECMO) for those babies with high blood pressure in the lungs or those who do not respond to other treatments. A pump and machine is used for this purpose.
- Operative delivery depending on how far the pregnancy has reached.
Meconium aspiration syndrome usually isn’t a life-threatening condition. Most infants with MAS would experience mild complications and typically recover within a few days. In rare occasions where newborn develop persistent pulmonary hypertension of the newborn (PPHN), they may experience lifelong health problems.
So, early detection is the key to prevent meconium aspiration syndrome. Additionally, fetal monitoring before delivery may help figure out the problem well in advance. In this case, the doctor can step-up and take proper action to prevent the fecal material from entering the baby’s body.
1. van Ierland Y and de Beaufort AJ(2009).Why does meconium cause meconium aspiration syndrome? Current concepts of MAS pathophysiology read more
2. Arcangela Lattari Balest(n.d.). Meconium Aspiration Syndrome read more
3. Whitfield JM et al.(2009). Prevention of meconium aspiration syndrome: an update and the Baylor experience read more