Management of meconium aspiration syndrome

Appropriate intrapartum care with early detection and management of fetal hypoxia is important in minimising the risk from meconium staining of amniotic fluid. However, there is no evidence to support the widespread practice of routine pharyngeal suction and/or endotracheal intubation in these babies. Treatment of established MAS is based on respiratory support with conventional mechanical ventilation and surfactant therapy. Alternative strategies such as inhaled nitric oxide and high-frequency ventilation and/or extracorporeal membrane oxygenation (ECMO) are reserved for babies with severe hypoxaemic respiratory failure with or without persistent pulmonary hypertension of the newborn.