Meconium Aspiration Syndrome Birth Injury

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Meconium aspiration syndrome birth injury (MAS) occurs when a newborn breathes in meconium (stool) and amniotic fluid. Also called neonatal aspiration of meconium, MAS is a medical condition that, if not detected and treated quickly, can lead to serious medical complications and permanent conditions such as cerebral palsy.

What Is Meconium Aspiration Syndrome?

Every newborn has meconium. It is an intestinal mixture of bile, intestinal fluids, amniotic fluid, and other substances.[1]

Meconium is a normal finding in the first hours to days after birth when babies have their first few stools. Some babies, however, release stool while still in the womb or during the childbirth process.

A baby can inhale the meconium when taking the first breaths if they stool while still in the womb. This is called aspiration and can lead to breathing difficulties from airway blockages. When this occurs, the condition is called meconium aspiration syndrome.

What Causes Meconium Aspiration?

MAS is caused by fetal distress.[2] Fetal distress can develop due to preeclampsia or chronic illness in the mother, placental complications, fetal anemia, restricted umbilical blood flow, and other issues.[3]

When a baby is distressed, oxygen levels in the blood can decrease, which causes an increase in intestinal activity. The baby’s anal sphincter will begin to relax and release meconium. The meconium then mixes in with the amniotic fluid surrounding the infant.

Between 5% and 10% of babies suffer from MAS at birth, but most recover fully.[4]

MAS During Labor

If a baby releases meconium during the labor process, it usually means that the infant is undergoing a long, difficult delivery. Other reasons meconium releases during labor include:

• The baby’s age (when a baby passes its due dates, the advanced gestational age increases the chances of stool being released during delivery)
• Umbilical cord problems, such as the cord being wrapped around the baby’s neck or having a knot in the cord
• Maternal smoking or drug use
• A mother with diabetes, high blood pressure, or respiratory problems
• Poor fetal growth (infants small for their gestational age)

Meconium Aspiration Symptoms

Not all infants will have every symptom, and some will have more signs and symptoms than others. Physicians look for the following issues when a baby has meconium aspiration.

• Dark stains mixed in the amniotic fluid, typically brown or dark green
• Green or blue staining on the infant’s skin
• Yellow nails and skin
• Breathing difficulties, grunting sounds, rapid breathing
• Low heart rate before birth
• Limp limbs
• Distended chest
• Low Apgar score
• Green urine
• Low fetal blood pressure

Meconium Aspiration Treatment

If MAS is detected, doctors should begin treatment immediately. If they identify breathing issues, physicians may need to intubate the infant.

This procedure is when a laryngoscope is inserted into the baby’s trachea. Then, endotracheal suctioning can be done to remove as much meconium as possible from the airway.[5]

Afterward, the medical team will carefully monitor the infant’s breathing, heartbeat, and general health. As part of managing meconium aspiration, a physician will usually order tests such as X-rays and a blood gas analysis, which help to see if the baby is getting enough oxygen.

Many babies with MAS will heal within a few days after treatment. Infants with severe MAS will need additional treatment, including antibiotics, oxygen therapy, time on a ventilator, nitric oxide inhalation treatment, and additional blood tests.

Some babies with severe aspiration will have an artificial surfactant placed into their lungs to help keep the air sacs open. This is known as surfactant therapy.[6] Other babies may need special ventilators with nitric oxide for treatment.

Do Babies Recover From MAS?

Babies severely affected by MAS will have a chemical irritation of the airways caused by the meconium. If this persists over time, the inflammation leads to lung injury.

Long-term respiratory complications from meconium aspiration can manifest as an oxygen requirement, severe asthma-like symptoms, poor growth, and frequent cases of viral or bacterial pneumonia.

Most infants recover from MAS if treated by an experienced medical team who acts quickly. Sometimes, a lack of action by doctors or a misdiagnosis can cause severe medical complications.

For instance, if a doctor detects meconium aspiration but fails to continually monitor the infant after birth, subsequent breathing problems could result in related medical issues.

Babies deprived of oxygen for too long can develop brain damage, which can lead to cerebral palsy, seizures, hypoxic-ischemic encephalopathy (HIE), and even stroke.

MAS and Medical Malpractice

Although most cases of MAS will resolve successfully, it is considered a serious disorder. There is a potential for long-term complications if MAS is not diagnosed and treated immediately.

It’s ultimately your doctor’s responsibility to continuously monitor your baby before, during, and after delivery for fetal stress and other signs. If they do not, they could be considered negligent.

If your baby was born with MAS and now has permanent disabilities, talk to a birth injury lawyer about your legal options.