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Meconium aspiration syndrome

Última revisão: 22 Jan 2026
Última atualização: 05 Apr 2024

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • signs of postmaturity
  • tachypnea
  • cyanosis
  • chest wall asymmetry with decreased air entry
  • barrel-shaped chest
Detalhes completos

Outros fatores diagnósticos

  • grunting
  • chest retractions
  • rales
  • rhonchi
  • tachycardia
  • hypotension
Detalhes completos

Fatores de risco

  • gestational age >42 weeks
  • pregnancy-induced hypertension
  • maternal diabetes mellitus
  • maternal smoking or substance misuse
  • fetal distress
  • oligohydramnios
  • thick meconium
  • Apgar score <7
  • chorioamnionitis
  • cesarean delivery
  • black ancestry
  • male sex
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • CXR
  • CBC
  • CRP
  • blood culture
Detalhes completos

Investigações a serem consideradas

  • dual pulse oximetry
  • ABG (pH, PaO₂, PaCO₂)
  • echocardiography
  • cranial ultrasound
  • electroencephalogram
  • urinalysis
Detalhes completos

Algoritmo de tratamento

AGUDA

vigorous infant born through meconium-stained amniotic fluid, no respiratory distress

mild MAS

moderate MAS

severe MAS

Colaboradores

Autores

Dharmapuri Vidyasagar, MD, MSc, FAAP, FCCM, PhD (Hon)
Dharmapuri Vidyasagar

Professor Emeritus

Department of Pediatrics

University of Illinois at Chicago

Chicago

IL

Visiting Professor

Department of Neonatology

Sri Ramachandra Medical College

Chennai

India

Declarações

DV is an author of a number of references cited in this topic. He has received royalties for editing the following books: Neonatal Ventilation (Elsevier India), Practical Neonatology (Indian Journal of Pediatrics), and Perinatal Cardiology (Cambridge Scholar publishing).

Rama Bhat, MD, FAAP

Professor of Pediatrics

Department of Pediatrics

University of Illinois at Chicago

Chicago

IL

Declarações

RB is an author of a reference cited in this topic.

Revisores

Ahmed Osman, MD

Assistant Professor of Pediatrics

Attending Neonatologist

Department of Pediatrics

The Ohio State University and Nationwide Children’s Hospital

Columbus

OH

Declarações

AO is an author of a reference cited in this topic.

Henry L. Halliday, MD, FRCPE, FRCP, FRCPCH

Professor

Retired Consultant Neonatologist

Royal Maternity Hospital

Honorary Professor

Department of Child Health

Queen's University Belfast

Belfast

UK

Declarações

HLH declares that he has no competing interests.

John Sinn, MBBS(Syd), Dip Paed, DCH, MMed (Clin Epi), FRACP (Paed)

Clinical Senior Lecturer

Obstetrics

Gynaecology and Neonatology

Royal North Shore Hospital and The University of Sydney

Sydney

Australia

Declarações

JS declares that he has no competing interests.

Créditos aos pareceristas

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Referências

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Principais artigos

Thornton PD, Campbell RT, Mogos MF, et al. Meconium aspiration syndrome: incidence and outcomes using discharge data. Early Hum Dev. 2019 Sep;136:21-6. Resumo

Singh BS, Clark RH, Powers RJ, et al. Meconium aspiration syndrome remains a significant problem in the NICU: outcomes and treatment patterns in term neonates admitted for intensive care during a ten-year period. J Perinatol. 2009 Jul;29(7):497-503. Resumo

Vidyasagar D, Harris V, Pildes RS. Assisted ventilation in infants with meconium aspiration syndrome. Pediatrics. 1975 Aug;56(2):208-13. Resumo

Wiswell TE, Gannon CM, Jacob J, et al. Delivery room management of the apparently vigorous meconium-stained neonate: results of the multicenter, international collaborative trial. Pediatrics. 2000 Jan;105(1 Pt 1):1-7. Resumo

Yamada NK, Szyld E, Strand ML, et al. 2023 American Heart Association and American Academy of Pediatrics focused update on neonatal resuscitation: an update to the American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2024 Jan 2;149(1):e157-66.Texto completo  Resumo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Meconium aspiration syndrome images
  • Diagnósticos diferenciais

    • Transient tachypnea of the newborn
    • Surfactant deficiency
    • Persistent pulmonary hypertension
    Mais Diagnósticos diferenciais
  • Diretrizes

    • 2023 American Heart Association and American Academy of Pediatrics focused update on neonatal resuscitation: An update to the American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care
    • Management of meconium at birth
    Mais Diretrizes
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