Resumen
Definition
History and exam
Key diagnostic factors
- presencia de factores de riesgo
- signos de parto postérmino
- taquipnea
- cianosis
- pared torácica asimétrica con disminución de la entrada de aire
- tórax en tonel
Other diagnostic factors
- gruñido
- depresión torácica
- estertores
- roncus
- taquicardia
- hipotensión
Risk factors
- edad gestacional >42 semanas
- hipertensión causada por el embarazo
- diabetes mellitus materna
- tabaquismo o abuso de sustancias por parte de la madre
- sufrimiento fetal
- oligohidramnios
- meconio denso
- puntuación de Apgar <7
- corioamnionitis
- parto por cesárea
- ancestros de raza negra
- sexo masculino
Diagnostic tests
1st tests to order
- radiografía del tórax (RT)
- hemograma completo (HC)
- proteína C-reactiva
- hemocultivo
Tests to consider
- oximetría de pulso doble
- GSA (pH, PaO₂, PaCO₂)
- ecocardiografía
- ultrasonido craneal
- electroencefalograma
- análisis de orina
Treatment algorithm
Bebé vigoroso nacido a través de líquido amniótico teñido de meconio, sin dificultad respiratoria
SAM leve
SAM moderado
SAM grave
Contributors
Authors
Dharmapuri Vidyasagar, MD, MSc, FAAP, FCCM, PhD (Hon)
Professor Emeritus
Department of Pediatrics
University of Illinois at Chicago
Chicago
IL
Visiting Professor
Department of Neonatology
Sri Ramachandra Medical College
Chennai
India
Disclosures
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
Disclosures
RB is an author of a reference cited in this topic.
Peer reviewers
Ahmed Osman, MD
Assistant Professor of Pediatrics
Attending Neonatologist
Department of Pediatrics
The Ohio State University and Nationwide Children’s Hospital
Columbus
OH
Disclosures
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
Disclosures
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
Disclosures
JS declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
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. Abstract
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. Abstract
Vidyasagar D, Harris V, Pildes RS. Assisted ventilation in infants with meconium aspiration syndrome. Pediatrics. 1975 Aug;56(2):208-13. Abstract
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. Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Taquipnea transitoria del recién nacido
- Deficiencia de surfactante
- Hipertensión pulmonar persistente
More DifferentialsGuidelines
- 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
More Guidelines
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