Meconium Aspiration Syndrome Lawsuits

Were you or your unborn baby the victim of a doctor’s negligence that led to a birth injury? Did the obstetrician make an error resulting in a meconium aspiration birth injury?

We have resolved many medical malpractice cases through million-dollar settlements to ensure families have sufficient financial compensation for providing all the treatment and care their child requires.

In pursuing a malpractice lawsuit against the delivery team, the personal injury lawyers at Rosenfeld Injury Lawyer, LLC can hold all responsible parties legally accountable to ensure your family has the financial resources to provide lifetime care to your injured newborn.

Call our birth injury attorneys today at (888) 424-5757 (toll-free phone call) or use the contact form to schedule a free case evaluation.

What Is Meconium Aspiration Syndrome?

Meconium is the dark green fecal matter in a fetus's intestines passed through the bowels (meconium passage) a few days after childbirth. However, the baby can pass the meconium into the amniotic fluid (meconium staining) while still in the uterus.

The reason is the different stresses on the fetus, such as regular contractions, infection, poor blood, or low oxygen.

Meconium is the first discharge from the intestines of a newborn. It does not contain any bacteria, is sterile, and is a thick substance that is a dark-green color. The meconium consists of:

• Intestinal epithelial cells
• Lanugo - soft hair that covers a fetus
• Mucosa
• Intestinal secretions such as bile
• Water which makes up 85% to 95% of meconium
• Proteins and lipids found in swallowed amniotic fluid

When a baby passes the meconium (meconium passage) immediately before or during delivery, it can sometimes be inhaled or aspirated through the amniotic fluid into the lungs. The infant may develop a complication known as meconium aspiration syndrome (MAS).

Inhaling the meconium-stained amniotic fluid can block the airways when the baby exhales, leading to abnormal breathing. Additionally, the newborn might have a meconium plug that can entirely block the airway. Meconium aspiration syndrome can result in severe complications, including chemical irritation to the lung tissue and infection.

The thicker the meconium is, the more dangerous it becomes when breathed into the fetus's lungs. Unfortunately, meconium aspiration is common before, during, and after delivery.

Meconium and Amniotic Fluid Aspiration

Meconium aspiration syndrome requires immediate medical attention and emergency cardiovascular care after childbirth.

Constant aftercare is needed in the following days, and the infant will generally be placed in the special care nursery or newborn intensive care unit. When adequately treated with suctioning and a course of antibiotics, most babies will fully recover from meconium aspiration syndrome (MAS).

Neonatal resuscitation might be required to restore the baby's breathing in cases where the newborn inhaled meconium. Less than 20 years ago, managing a newborn delivery with meconium-stained amniotic fluid required suctioning the nasopharynx(top of the throat) and oropharynx(back of the mouth).

New neonatal resuscitation guidelines no longer support this practice because data shows that routine intrapartum (occurring during labor or delivery) suctioning fails to alter or prevent meconium aspiration syndrome.

However, new guidelines support intubation of the trachea and suctioning from beneath the vocal cords (glottis) of the larynx in severe cases where the newborn is not active.

Signs of Meconium Aspiration Syndrome (MAS)

Any obstetrician should know the dangers and signs of meconium aspiration syndrome. Infants born with meconium in the amniotic fluid are at a much higher risk of developing respiratory diseases and other complications.

When babies pass meconium during a bowel movement, and it is released into the amniotic fluid, it is visible as a dark green color. It should be the first sign that the child may have breathed in the substance in utero or while they are in the birth canal.

When this occurs, the medical team must take appropriate action immediately. In addition, the newborn baby often will have symptoms of meconium aspiration such as:

• Troublebreathing, breathing is labored
• Air trapping (retention of air in the lungs where the baby is unable to exhale properly or entirely)
• Barrel chest due to the trapped air
• Tachypnea (rapid breathing)
• Nasal flaring
• Lowered body temperature (using a radiant warmer can increase and maintain the temperature)
• Grunt when they breathe
• Use extra muscles to catch their breath
• Retractions or pulling in of the chest wall
• Low Apgar score,which shows the color, heart rate, reflexes, muscle tone, and respiratory effort of baby
• Skin can have a bluish tint due to lack of oxygen (cyanosis)
• Skin can have a greenish tint due to being meconium-stained
• Low blood pressure
• Limpness

The meconium aspiration causes hypoxia(below-normal level of oxygen in the blood) with four significant pulmonary effects:

• Airway obstruction
• Surfactant dysfunction (lung disorder causing breathing problems)
• Chemical pneumonitis
• Pulmonary hypertension

How Is Meconium Aspiration Syndrome Diagnosed?

The doctor should use a fetal monitor to prevent complications with near-term infants at risk for meconium aspiration syndrome or another complicated birth injury, like cerebral palsy.

The first sign of MAS would be restricted blood flow or oxygen or the infant having a slow heart rate. It will require immediate intervention to restore oxygenated blood flow.

If the doctor cannot fully restore oxygenated blood, he likely has no other option than to perform an emergency delivery. The results of any failure to monitor the infant properly or a delay in the emergency delivery could be catastrophic, leading to severe brain damage or even death of the newborn.

Doctors may identify issues with the umbilical cord or placenta if the expected due date is past due, leading to blood or oxygen deprivation. Any delay in an expected delivery or emergency C-section could cause severe injury, permanent brain damage, or newborn death.

The following tests can be ordered to check for bacteria or other potential infections:

• Acid-base status - Assessing the baby’s acid base is important as perinatal stress can affect the base status. The test uses cord blood to evaluate the arterial blood gas (ABG), measuring carbon dioxide and oxygen levels and providing a baseline.
• Serum electrolytes - This test should be performed within 24 hours after delivery to check the baby’s sodium, calcium and potassium levels. Infants with meconium aspiration syndrome generally have an incorrect secretion of antidiuretic hormones. Acute renal failure is a risk with perinatal stress, making kidney-and-liver function examination critical.
• Complete blood cell count (CBC) - A CBC test is a blood test that is the first indicator of conditions or infections like anemia or leukemia and measures all the components of blood, such as:
  1. Red blood cells - provide oxygen
  2. White blood cells - fight infection
  3. Hemoglobin - a protein that carries oxygen
  4. Hematocrit - the proportion of plasma to red blood cells
  5. Platelets - help blood clot

Treating Meconium Aspiration Syndrome

When the infant inhales their first stool in the amniotic fluid, the occurrence of meconium aspiration syndrome requires immediate treatment to ensure that the meconium is removed from the upper airway. After childbirth, the physician will immediately suction the throat, mouth, and nose to remove any meconium inhaled in the womb or during delivery.

A tube is inserted into their windpipe (trachea) to suction the amniotic fluid containing meconium from the windpipe, allowing oxygen to flow into the lungs. The physician will likely start cardiopulmonary resuscitation measures if the newborn does not breathe or has no heart rate.

If the newborn is still not breathing or has trouble breathing, the doctor could use a bag and mask to help deliver supplemental oxygen to the baby's lungs through inflation. The medical team must monitor the baby closely to identify any life-threatening injury caused by decreased oxygen supply.

Emergency treatment for respiratory distress might be the only recourse to avoid serious complications associated with meconium aspiration. Other treatments doctors use to overcome the most common indicators of meconium aspiration syndrome include:

• Oxygen therapy to ensure that the blood is oxygenated
• Frequent blood tests to check that there is enough oxygen in the blood
• Using a radiant warmerto help maintain the baby's body temperature
• Administering antibiotics,including gentamicin and ampicillin, to treat or prevent infection
• Using mechanical ventilation such as a ventilator (breathing machine) to encourage breathing
• Extracorporeal membrane oxygenation to help the newborn respondto treatments or perform lung function if there is high blood pressure in the lungs
• Chest physiotherapy by tapping on the baby’s chest to loosen secretions
• Surfactant therapy is also known as surfactant administration or surfactant lavage
• Steroid therapy to calm the inflammatory response of meconium in the airways

Meconium staining on the child's vocal cords observed through a laryngoscope indicates MAS as dark green or brownish staining in the mother's amniotic fluid. Any sign of limpness in the newborn at birth, coupled with either breathing problems, respiratory distress, or a total absence of breathing, with bluish skin color, could indicate severe meconium aspiration syndrome.

Medical professionals might analyze the newborn's blood with blood gas analysis to determine if the blood has low pH (acidic) or if the child has increased carbon dioxide and a lack of oxygen. In addition, using a stethoscope to listen to the baby's chest could detect abnormal breath sounds and children reacting to meconium aspiration syndrome.

Inhaling nitric oxide to treat persistent pulmonary hypertension is highly effective in infants with MAS. Studies show that the inhaled nitric oxide made a significant difference in newborn survival and babies with pulmonary hypertension, MAS, or another respiratory birth injury, like cerebral palsy.

Causes and Risk Factors of Meconium Aspiration Syndrome (MAS)

Most severe cases of meconium aspiration syndrome derive from the fact that the baby suffered some form of fetal distress during the birthing process, causing them to ingest fecal matter after its released in a bowel movement.

When babies are not getting an adequate supply of blood and oxygen, their bodies are thought to respond to the stress by expelling meconium. Under pressure, the baby's intestines will expel thick meconium.

Knowing the complications that can ensue following fetus distress, health care providers must carefully monitor the baby's health, especially to detect the presence of meconium staining. A fetal monitor can determine complications at their onset.

Most babies immediately treated for meconium aspiration syndrome will most likely have complete recovery of pulmonary function. However, when these signs are ignored due to negligence in severe birth injury cases, the infant is in danger of severe health problems.

The medical team must know the risk factors for meconium aspiration syndrome and perform the appropriate diagnostic tests to protect the infant.

Mothers who take care of themselves during their pregnancy and follow their doctor’s advice can often prevent the presence of meconium at birth. Some of the risk factors associated with MAS are:

• Smoking during the pregnancy
• Pregnancy passes the 40-week mark
• Maternal diabetes
• Maternal hypertension (high blood pressure)
• Prolonged labor
• A difficultbirth, such as a breech presentation
• Decreased oxygen to infant while in utero
• Poor growth of fetus intrauterine
• Intra-uterine hypoxia (fetus does not receive the right amount of oxygen while in the uterus)
• Preeclampsia
• Pulmonary hypertension of the fetus due to chronic in utero stress and thickening of pulmonary vessels

Serious Complications Derived From Untreated MAS

The infant likely has had a difficult birth when MAS occurs, causing utero hypoxia or fetal distress. The attending doctor and nursing staff are responsible for being aware of any possible problems arising from the stress of labor, including inhaled meconium and MAS.

When medical professionals do not give an infant the appropriate treatment for this condition, the infant will often have trouble breathing, with a continual shortage of oxygen. As a result, the lungs can be significantly compromised, leading to a lifelong birth injury.

Due to these complications, newborn infants may suffer a birth injury, including:

• Aspiration pneumonia
• Collapsed lung
• Congenital heart disease
• Congenital diaphragmatic hernia
• Sepsis
• Reactive airway disease
• Surfactant dysfunction
• Pulmonary infection
• Neonatal respiratory disorders
• Chemical pneumonitis
• Brain damage or another brain injury
• Cerebral Palsy
• Persistent pulmonary hypertension- inability to get adequate oxygen supply throughout the body

When the baby inhales meconium, these complications can lead to permanent mental and physical disabilities, especially brain damage. The true extent of the damage may not be noticeable at first, but as the child develops,cognitive and behavioral issues may become apparent.

These can be lifelong disabilities that can cause physical, emotional, and financial problems for both the child and their family.

Meconium Aspiration and Medical Negligence

In cases involving meconium aspiration syndrome, meconium is the bile-stained odorless content in the fetus's bowel intestine that develops between the 10th and 16th weeks of pregnancy. Meconium-stained amniotic fluid is not a critical risk factor for the fetus in the womb but could be devastating for the newborn.

Up to 20% of all live births involve meconium, and in about 10% of cases, meconium is found in amniotic fluid that could get into the baby's lungs, causing MAS.

Typically, MAS results from a failure to deal with the increased risk to the infant born when exposed to meconium. However, other cases involve malpractice where meconium led to a preventable birth injury.

A knowledgeable medical malpractice attorney can investigate what caused meconium aspiration syndrome. The lawyer can evaluate whether the medical professionals were negligent by delaying childbirth while the fetus was in distress or experiencing MAS after birth.

Birth Injury Lawyers Prosecuting Meconium Aspiration Cases

Rosenfeld Injury Lawyers LLC works with leading doctors who can evaluate meconium aspiration syndrome cases. Our law firm uses the services of a life-care planner who assesses the requirements of each child for their immediate and long-term care needs.

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Call our law office today at (888) 424-5757 to schedule a free initial consultation to learn more about your legal options, our legal services, and what you can expect from the process. All confidential or sensitive information you share remains private through an attorney-client relationship.

Resources:

• National Institute of Health – Meconium Aspiration Syndrome
• Johns Hopkins Medicine – Meconium Aspiration Syndrome