Gorovitz & Borten, P.C.
Attorneys at Law

400 Totten Pond Road, 2nd Floor
Waltham, Massachusetts 02451
Tel: (781) 890-9095
Meconium Aspiration
Meconium aspiration is defined as the presence of meconium below the vocal
cords in a newborn. Meconium aspiration may lead to the development of
Meconium Aspiration Syndrome (MAS) which develops shortly after birth.
Meconium aspiration may produce conditions ranging from transient respiratory
distress to severe respiratory difficulty causing the death of the newborn in up
to 10% of cases.

Meconium is the material found in the intestine of a newborn. Meconium first
appears in the gut at approximately 10 weeks of gestation. Rarely is meconium
passed from the fetus into the amniotic fluid before 34 weeks of gestation
because a mature gastrointestinal tract is required for a fetus to pass
meconium into the amniotic cavity.

Meconium has been classified in accordance with its consistency into thin
meconium and thick or particulate meconium. Although thin meconium can be
present in up to 40% of cases, the appearance of thick meconium has the most
clinical significance. The risk of perinatal death is increased 5 to 7 times when
thick meconium is present at the onset of labor. This finding is generally
associated with oligohydramnios (low volume of amniotic fluid). The presence of
meconium prior to the onset of labor denotes an event that is unrelated to the
stress of labor. Meconium detected during labor after clear fluid was detected
indicates an acute event associated with the process of labor.

Factors that are associated with the appearance of fetal distress and promote
the passage of meconium in utero include the following:


  • Placental insufficiency
  • Oligohydramnios
  • Chorioamnionitis (maternal infection)
  • Maternal hypertension
  • Preeclampsia
  • Smoking
  • Drug abuse
  • Fetal gasping secondary to fetal hypoxia

There is strong evidence that meconium passage in-utero is influenced by the
following factors:

  • Physiologic maturational event
  • Response to acute hypoxic event (even in the absence of labor)
  • Response to chronic intrauterine hypoxia

Diagnosis of the underlying conditions that promote meconium passage in-
utero and appropriate treatment which may include early operative delivery
have been recommended. Although no single intervention can prevent the
appearance of meconium aspiration syndrome, a decline in incidence and
severity of complications have been associated with:

  • Early determination of meconium passage by amniotomy
  • Antepartum fetal monitoring
  • Continuous electronic fetal monitoring in labor
  • Amnioinfusion during labor
  • Suctioning of pharynx and trachea at birth
  • Physiotherapy and Saline lavage  

Infants who suffer an acute hypoxic event just before or after the onset of labor
are more likely to pass thick meconium and suffer meconium aspiration
syndrome. Similarly, infants who suffer from chronic hypoxia promote the
passage of meconium and fetal gasping. Prompt intervention may prevent or
reduce the severity of meconium aspiration syndrome. Infants with meconium
aspiration syndrome may benefit from the administration of surfactant in
conjunction with other therapeutic approaches.

If your child was born and suffered meconium aspiration syndrome, allow
Dr.
Borten and our Boston area medical malpractice attorneys at Gorovitz & Borten
to review your medical records. We can help you assert your rights and get the
compensation you deserve.
Contact Information
For a free confidential consultation and receive a response within 24 hours
(when possible), please contact us by phone, fax or e-mail with your question or
concern.

Telephone:  781-890-9095     -     Fax:   781-890-9098
                                                                                               
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