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Meconium Aspiration

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Radiological Imaging of the Neonatal Chest

Part of the book series: Medical Radiology ((Med Radiol Diagn Imaging))

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Abstract

Aristotle originally coined the term ‘meconium’. He used the Greek word meconium-arion to mean ‘opium like’ (Wiswell and Bent 1993), as he believed that meconium precipitated fetal sleep. It is probable that he recognised the association between the presence of the meconium in the amniotic fluid and subsequent fetal death or neonatal depression. Depending on the population studied, the frequency of meconium-stained amniotic fluid (MSAF) at delivery varies between approximately 8% and 19% of all term deliveries (Gregory et al. 1974; Wiswell et al. 1990; Suresh and Sarkar 1994; Falciglia et al. 1992; Nathan et al. 1994; Yoder 1994; Peng et al. 1996). Other factors, such as maternal ethnicity, result in a higher prevalence of meconium aspiration syndrome (MAS): the prevalence of MSAF in black is 1.5-fold that in white women (Alexander et al. 1994), and the likelihood of MSAF in creases with advancing gestational age in all ethnic groups.

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References

  • Abu-Osa YK (1991) Treatment of persistent pulmonary hypertension of the newborn: update. Arch Dis Child 66:74–77

    Article  Google Scholar 

  • Akopov SE, Zhang L, Pearce WJ (1998) Maturation alters the contractile role of calcium in ovine basilar arteries. Pediatr Res 44:154–60

    Article  CAS  PubMed  Google Scholar 

  • Alexander GR, Hulsey TC, Robillard P-Y et al (1994) Determinants of meconium-stained amniotic fluid in tern pregnancies. J Perinatol 14:259–263

    CAS  PubMed  Google Scholar 

  • Andrews AF, Klein MD, Tomasian JM, Roloff DW, Bartlett RH (1983) Venovenous extracorporeal membrane oxygenation in neonates with respiratory failure. J Pediatr Surg 18:339–346

    Article  CAS  PubMed  Google Scholar 

  • Antunes MJ, Friedman M, Greenspan JS et al (1997) Meconium decreases surfactant protein B levels in rat fetal lung explants. Pediatr Res 41:137 (abstract)

    Article  Google Scholar 

  • Bartlett RH, Gazzinga AZ, Huxtable RF et al (1977) Extracorporeal circulation (ECMO) in neonatal respiratory failure. J Thorac Cardiovasc Surg 74:826–833

    CAS  PubMed  Google Scholar 

  • Berkus MD, Langer O, Samueloff A et al (1994) Meconiumstained amniotic fluid: increased risk for adverse neonatal outcomes. Obstet Gynecol 84:115

    CAS  PubMed  Google Scholar 

  • Clark DA, Nieman GF, Thompson JE et al (1987) Surfactant displacement by meconium free fatty acids: an alternative explanation for atelectasis in meconium aspiration syndrome. J Pediatr 110:765–170

    Article  CAS  PubMed  Google Scholar 

  • Cleary GM, Wiswell TE (1999) Meconium-stained amniotic fluid and the meconium aspiration syndrome. An update (review). Pediatr Clin North Am 45:511–529

    Article  Google Scholar 

  • Collaborative ECMO trial group (1996) UK collaborative randomised trial of neonatal extracorporeal membrane oxygenation. Lancet 341:75–82

    Google Scholar 

  • Coltart TM, Byrne DL, Bates SA (1989) Meconium aspiration syndrome: a 6 year retrospective study. Br J Obstet Gynaecol 96:411–414

    CAS  PubMed  Google Scholar 

  • Delius R, Anderson H, Schumacher R et al (1993) Venovenous compares favourably with venoarterial access for extracorporeal membrane oxygenation in neonatal respiratory failure. J Thorac Cardiovasc Surg 106:329–338

    CAS  PubMed  Google Scholar 

  • Desai SA, Stanley C, Gringlas M et al (1999) Five year followup of neonates with reconstructed right common carotid arteries after extracorporeal membrane oxygenation. J Pediatr 134:428–433

    Article  CAS  PubMed  Google Scholar 

  • Falciglia HS, Henderschott C, Potter P et al (1992) Does DeLee suction at the perineum prevent meconium aspiration syndrome? Am J Obstet Gynecol 167:1243–1249

    CAS  PubMed  Google Scholar 

  • Findlay RD, Taeusch HW, Walther FJ (1996) Surfactant replacement therapy for meconium aspiration syndrome. Pediatrics 97:48

    CAS  PubMed  Google Scholar 

  • Fleischer A, Anyaegbunam A, Guidette D et al (1992) A persistent clinical problem: profile of the term infant with significant respiratory complications. Obstet Gynecol 79:185–190

    CAS  PubMed  Google Scholar 

  • Fox WW, Duara S, (1983) Persistent pulmonary hypertension in the neonate. J Pediatr 103:505–514

    Article  CAS  PubMed  Google Scholar 

  • Fuloria M, Wiswell TE (1999) Resuscitation of the meconium-stained infant and prevention of meconium aspiration syndrome. J Perinatol 19:234–241

    Article  CAS  PubMed  Google Scholar 

  • Goetzman BW (1992) Meconium aspiration. Am J Dis Child 146:1282

    CAS  PubMed  Google Scholar 

  • Gregory GA, Gooding CA, Phibbs RH et al (1974) Meconium aspiration in infants: a prospective study. J Pediatr 85:848–852

    Article  CAS  PubMed  Google Scholar 

  • Higgins ST, Wu A-M, Sen N et al (1996) Meconium increases surfactant secretion in isolated rat alveolar type II cell. Pediatr Res 39:443–447

    Article  CAS  PubMed  Google Scholar 

  • Holopainen R, Aho H, Laine J, Halkola L, Kaapa P (1999) Nitric oxide inhalation inhibits pulmonary apoptosis but not inflammatory injury in porcine meconium aspiration. Acta Paediatr 88:1147–1455

    Article  CAS  PubMed  Google Scholar 

  • Holtzman RB, Banzhaf WC, Silver RK et al (1989) Perinatal management of meconium staining of the amniotic fluid. Clin Perinatol 16:825–838

    CAS  PubMed  Google Scholar 

  • Jacobs JP, Goldman AP, Cullen S et al (1997) Carotid artery pseudonaeurysm as a complication of ECMO. Ann Vasc Surg 11:630–633

    Article  CAS  PubMed  Google Scholar 

  • Klein MD Andrews AF Wesley JR et al (1985) Venovenous perfusion in ECMO for newborn respiratory insufficiency. Ann Surg 210:520–526

    Google Scholar 

  • Lien HM, Towers CV, Quilligan EJ et al (1995) Term early-onset neonatal seizures: obstetric characteristics, etiologic classifications, and perinatal care. Obstet Gynecol 85:163–169

    Article  CAS  PubMed  Google Scholar 

  • Lillehei CW, O’Rourke PP, Vacanti JP, Crone RK (1989) Role of extracorporeal membrane oxygenation in selected pediatric respiratory problems. J Thorac Cardiovasc Surg 98:968–970

    CAS  PubMed  Google Scholar 

  • Lucas A, Adrian TE, Christofides N et al (1980) Plasma motilin, gastrin, and enteroglucagon and feeding in the human newborn. Arch Dis Child 55:673–677

    Article  CAS  PubMed  Google Scholar 

  • Macfarlane PI, Heaf DP (1988) Pulmonary function in children after neonatal meconium aspiration syndrome. Arch Dis Child 63:368–372

    Article  CAS  PubMed  Google Scholar 

  • Matthews TG, Warshaw JB (1979) Relevance of the gestational age distribution of meconium passage in utero. Pediatrics 64:30–31

    CAS  PubMed  Google Scholar 

  • Miller FC, Read JA (1981) Intrapartum assessment of the postdate fetus. Am J Obstet Gynecol 141:516–520

    CAS  PubMed  Google Scholar 

  • Moses D, Holm BA, Spitale P et al (1991) Inhibition of pulmonary surfactant function by meconium. Am J Obstet Gynecol 164:477–481

    CAS  PubMed  Google Scholar 

  • Mok JYQ Simpson H (1984) Outcome of acute bronchitis, bronchiolitis and pneumonia in infancy. Arch Dis Child 59:306–309

    Article  CAS  PubMed  Google Scholar 

  • Murphy JD, Rabinovitch M, Goldstein JD et al (1981) The structural basis of persistent pulmonary hypertension of the newborn. J Pediatr 98:962–967

    Article  CAS  PubMed  Google Scholar 

  • Murphy JD, Vawter GF, Reid LM (1984) Pulmonary vascular disease in fatal meconium aspiration. J Pediatr 104:758

    Article  CAS  PubMed  Google Scholar 

  • Narang A, Nair PMC, Bhakoo O et al (1993) Management of meconium stained amniotic fluid: a team approach. Indian Pediatr 30:9–13

    CAS  PubMed  Google Scholar 

  • Nathan L, Leveno KJ, Carmody TJ et al (1994) Meconium: a 1990s perspective on an old obstetric hazard. Obstet Gynecol 83:329–332

    CAS  PubMed  Google Scholar 

  • Oelberg DG, Downey SA, Flynn MM (1990) Bile salt-induced intracellular Ca+ + accumulation in type II pneumocytes. Lung 168:297

    Article  CAS  PubMed  Google Scholar 

  • Peek GJ, Firmin RK, Moore HM, Sosnowski AW (1996) Cannulation for neonates for venovenous extracorporeal life support. Ann Thorac Surg 61:1851–1852

    Article  CAS  PubMed  Google Scholar 

  • Peng TCC, Gutcher GR, Van Dorsten JP (1996) A selective aggressive approach to the neonate exposed to meconiumstained amniotic fluid. Am J Obstet Gynecol 175:296–303

    Article  CAS  PubMed  Google Scholar 

  • Roberts JD, Fineman JR, Morin FC et al (1997) Inhaled nitric oxide and persistent pulmonary hypertension of the newborn. N Engl J Med 336:605

    Article  CAS  PubMed  Google Scholar 

  • Stocker JT (1992) The respiratory tract. In: Stocker JT, Dehner LP (eds) Pediatric pathology. Lippincott, Philadelphia, p 505

    Google Scholar 

  • Sun B, Curstedt T, Robertson B (1993) Surfactant inhibition in experimental meconium aspiration. Acta Paediatr 82:182–189

    Article  CAS  PubMed  Google Scholar 

  • Suresh GK, Sarkar S (1994) Delivery room management of infants born through thin meconium stained liquor. Indian Pediatr 31:1177–1181

    CAS  PubMed  Google Scholar 

  • Swaminathan S, Quinn J, Stabile MW et al (1989) Long-term pulmonary sequelae of meconium aspiration syndrome. J Pediatr 114:356–361

    Article  CAS  PubMed  Google Scholar 

  • The Neonatal Inhaled Nitric Oxide Study Group (1997) Inhaled nitric oxide in full-term and nearly full term infants with hypoxic respiratory failure. N Engl J Med 336:597

    Article  Google Scholar 

  • Thureen PJ, Halliday HL, Hoffenberg A et al (1997) Fatal meconium aspiration in spite of appropriate perinatal airway management: pulmonary and placental evidence of prenatal disease. Am J Obstet Gynecol 176:967–975

    Article  CAS  PubMed  Google Scholar 

  • Ting P, Brady JP (1975) Tracheal suction in meconium aspiration. Am J Obstet Gynecol 122:767–771

    CAS  PubMed  Google Scholar 

  • Tran N, Lowe C, Sivieri EM et al (1980) Sequential effects of acute meconium aspiration on pulmonary function. Pediatr Res 14:34–38

    CAS  PubMed  Google Scholar 

  • Tsu F, Yeh MD, Harris V et al (1979) Roentgenographic findings in infants with MAS. JAMA 242:60–62

    Article  Google Scholar 

  • Tyler DC, Murphy J, Cheney FW (1978) Mechanical and chemical damage to lung tissue caused by meconium aspiration. Pediatrics 62:454–459

    CAS  PubMed  Google Scholar 

  • Usher RH, Boyd ME, McLean FH et al (1988) Assessment of fetal risk in postdate pregnancies. Am J Obstet Gynecol 158:259–264

    CAS  PubMed  Google Scholar 

  • Wiswell TE, Bent RC (1993) Meconium staining and the meconium aspiration syndrome. Pediatr Clin North Am 40:955–981

    CAS  PubMed  Google Scholar 

  • Wiswell TE, Tuggle JM, Turner BS (1990) Meconium aspiration syndrome: have we made a difference? Pediatrics 85:715–721

    CAS  PubMed  Google Scholar 

  • Wiswell TE, Foster NH, Slayter MV et al (1992) Management of piglet model of he meconium aspiration syndrome with high frequency or conventional ventilation. Am J Dis Child 146:1287

    CAS  PubMed  Google Scholar 

  • Wiswell TE, Meconium in the Delivery Room Trial Group (1998) Delivery room management of the apparently vigorous meconium-stained neonate: results of the multicentre collaborative trial. Pediatr Res 43:23 (abstract)

    Google Scholar 

  • Yeh TF, Harris V, Srinivasan G et al (1979) Roentgenographic findings in infants with meconium aspiration syndrome. JAMA 242:60–63

    Article  CAS  PubMed  Google Scholar 

  • Yeh TF, Lilien LD, Barathi A et al (1982) Lung volume, dynamic lung compliance, and blood gases during the first 3 days of postnatal life in infants with meconium aspiration syndrome. Crit Care Med 10:588–592

    Article  CAS  PubMed  Google Scholar 

  • Yoder BA (1994) Meconium-stained amniotic fluid and respiratory complications: impact of selective tracheal suction. Obstet Gynecol 83:77–84

    CAS  PubMed  Google Scholar 

  • Yuksel B, Greenough A, Gamsu HR (1993) Neonatal meconium aspiration syndrome and respiratory morbidity during infancy. Pediatr Pulmonol 16:358–361

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Radiology Department, Great Ormond Street Hospital for Sick Children NHS Trust, London, WC1N 3JH, UK

    Catherine M. Owens MD

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  1. Catherine M. Owens MD
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Editors and Affiliations

  1. Department of Radiology, Children’s University Hospital, Temple Street, Dublin 1, Ireland

    Veronica Donoghue MD (Consultant Pediatric Radiologist) (Consultant Pediatric Radiologist)

  2. The National Maternity Hospital, Holles Street, Dublin 2, Ireland

    Veronica Donoghue MD (Consultant Pediatric Radiologist) (Consultant Pediatric Radiologist)

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© 2008 Springer-Verlag Berlin Heidelberg

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Owens, C.M. (2008). Meconium Aspiration. In: Donoghue, V. (eds) Radiological Imaging of the Neonatal Chest. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-33749-2_6

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  • DOI: https://doi.org/10.1007/978-3-540-33749-2_6

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-33748-5

  • Online ISBN: 978-3-540-33749-2

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