SEVERE MECONIUM ASPIRATION SYNDROME: CASE REPORT

Abstract

This is a case report on severe meconium aspiration syndrome (MAS) that resulted in early neonatal
death. Antenatal care was provided at a low-cost non-governmental organization (NGO) clinic. First
stage of labour lasted for only 2 hours and 45 minutes. There were no foetal heart rate abnormalities
that were noted during the first stage of labour. Artificial rupture of membranes was done in second
stage of labour. There was no liquor amnii seen but scanty thick old meconium was noted. Delivery
was easy. The baby’s skin, nails, umbilical cord, placenta and vernix were deeply stained yellow
with old meconium. Resuscitation included suction through direct laryngoscopy, nasotracheal
intubation with pulmonary toilet, as well as administration of 100% oxygen. The condition of the
baby did not improve. A diagnosis of severe MAS with hypoxic ischaemic encephalopathy (HIE),
persistent pulmonary hypertension (PPH), persistent foetal circulation syndrome (PFCS) and
meconium chemical pneumonitis was made. The baby was admitted to the intensive care unit (ICU)
for assisted ventilation and critical care. The condition of the baby continued to deteriorate and
demise occurred 18 hours after birth. The pathophysiologic processes of intrauterine meconium
release, mechanisms of foetal effects and dilemmas in management are discussed.