Meconium Aspiration Syndrome and Birth Injuries

On this page, we will look at meconium aspiration syndrome, a potentially dangerous complication that can arise during childbirth. We will explain what this condition is and how mismanagement of it through medical negligence can lead to devastating birth injuries. We will also look at settlements and verdicts involving meconium aspiration malpractice.

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Meconium Aspiration Syndrome

Meconium aspiration syndrome (MAS) is a potentially dangerous condition that occurs during childbirth when a baby inhales meconium mixed with amniotic fluid.

Meconium is a baby’s first stool, which is a thick, dark-green, viscous substance typically excreted in the first few days after birth. Sometimes, a baby will pass meconium in the womb towards the end of pregnancy, mixing with the amniotic fluid. MAS happens when this meconium is discharged inside the womb and inhaled into the baby’s lungs before birth. This can lead to serious health risks and complications for the newborn. If not properly treated, MAS can result in permanent injury or even death.

Causes of Meconium Aspiration Syndrome

MAS occurs when a baby discharges meconium inside the womb and then inhales it. Typically, a baby does not release meconium until after birth. Understanding the causes of MAS involves identifying what triggers meconium discharge inside the womb. This early discharge is often due to fetal stress or abnormalities with the placenta. Fetal distress in the later stages of pregnancy is usually related to some form of oxygen deprivation or reduction to the fetus. Common causes of fetal distress and/or oxygen interruption leading to MAS include:

– Post-term pregnancy (beyond 40 weeks)

– Prolonged or traumatic labor

– Maternal health issues such as preeclampsia or gestational diabetes

– Maternal infection

Post-term pregnancy is strongly linked to an increased risk of MAS. Babies start producing meconium in the final stages of pregnancy, so the longer the pregnancy extends past the due date, the more likely the baby will discharge meconium in the womb. Additionally, as the pregnancy continues beyond the due date, the amniotic fluid level decreases, making any meconium discharge more concentrated.

Diagnosis of MAS

MAS is typically diagnosed immediately by doctors and nurses in the labor and delivery room after birth. When meconium is discharged inside the womb, it usually stains the amniotic fluid, which is often the first warning sign of MAS and is easily noticeable. If meconium-stained amniotic fluid is present, doctors will carefully assess the baby for additional signs of MAS, usually by listening to the chest, though x-rays may also be used.

For reasons that are not fully understood, African-American newborns experience meconium aspiration syndrome 50% more often than white newborns.

Treatment and Management of MAS

Babies with MAS require immediate intervention and treatment. The initial treatment typically involves manually removing meconium and amniotic fluid from the baby’s airways. The doctor will first clear any fluid by hand, followed by the use of a suction tube to gently dislodge and remove any remaining meconium-stained fluid.

Once the initial suctioning is complete, the baby’s respiratory function is reassessed. If the baby continues to have difficulty breathing, the next step is usually to use a bag/mask ventilation device to facilitate oxygen delivery. This helps get oxygen to the baby’s organs and inflates the lungs, aiding in the removal of remaining meconium and fluid.

If the baby still struggles to breathe after suctioning and ventilation, the next level of treatment involves the surgical insertion of a breathing tube. This tube is placed in the baby’s windpipe and connected to a mechanical ventilation machine. Babies needing this level of intervention are typically placed in the NICU.

After the emergency treatments, follow-up monitoring and treatment are crucial to avoid potential complications. Common follow-up care for MAS includes:

– Oxygen therapy

– Placing the baby under a radiant warmer to maintain body temperature

– Antibiotics to prevent infections associated with MAS

– Mechanical breathing devices (if necessary)

In severe cases of MAS, where the baby cannot breathe independently or has very high blood pressure in the lungs, extracorporeal membrane oxygenation (ECMO) may be necessary. ECMO involves hooking the baby up to a complex machine that performs the functions of the lungs and heart.

Complications from Negligent Mismanagement of MAS

MAS can usually be effectively managed and treated without long-term health complications or injuries. Approximately 10%-15% of pregnancies involve meconium-stained amniotic fluid, but only about 0.2% (2 out of 1000) of these infants develop MAS.

However, if MAS is not properly treated, the risks can be severe. MAS primarily causes respiratory issues and is a major contributor to serious respiratory disease. The presence of meconium often triggers inflammation and infection in the lungs, with infection being the most common complication associated with MAS.

Another potential complication is the over-expansion of the lungs. When airways are obstructed by MAS, the air pockets in the lungs may over-expand in an attempt to get more oxygen. If the lungs over-expand or inflate too much, they can potentially rupture or collapse. A lung rupture can lead to air escaping into the chest cavity (a condition called pneumothorax), which makes it very difficult to inflate and repair the lung. Lung rupture or collapse is one of the most dangerous complications associated with MAS.

MAS also increases a baby’s risk of developing persistent pulmonary hypertension of the newborn (PPHN). PPHN is a rare but potentially life-threatening condition where high pressure in the blood vessels around the lungs restricts circulation, making it very difficult for the baby to breathe.

Medical Malpractice for Mismanagement of MAS

If a doctor or hospital delivery team is negligent in failing to properly diagnose, manage, and/or treat meconium aspiration syndrome, it can have devastating consequences for the baby. Failure to properly manage MAS when it occurs can cause neonatal respiratory problems that can sometimes be life-threatening.

The standard of care for the management of MAS requires doctors and hospital staff to timely recognize and diagnose MAS when it occurs. A delay or failure in diagnosis of MAS can be very harmful because early intervention is critical.

Once MAS is diagnosed, the doctor and delivery team need to promptly respond with the appropriate treatment to minimize the risk to the baby. Failure to timely intervene and clear the baby’s airways, or provide appropriate treatment can harm the baby and be considered negligent medical care.

Meconium Aspiration Verdicts & Settlements

Below are summaries of birth injury malpractice verdicts and settlements involving allegations that the baby’s injuries were related to the negligent management or diagnosis of meconium aspiration.

$1,318,000 Settlement (New York): Lawsuit alleged that the defendant midwife was negligent in her plan of care for the labor and delivery. The plaintiff claimed that this resulted in an unnecessary delay in the baby’s delivery and that this delay caused meconium aspiration to occur. As a result, the baby suffered respiratory distress and the lack of oxygen caused neurologic damage.

$2,500,000 Settlement (California): The defendants were alleged to be negligent in failing to intervene with an emergency C-section in response to signs of fetal distress caused by meconium aspiration during labor. As a result of the respiratory failure caused by the meconium aspiration, the baby allegedly suffered HIE during birth which left him with permanent brain damage.

$975,000 Settlement (California): The newborn baby reportedly suffered severe developmental and cognitive delays, cerebral palsy, ADHD and learning difficulties as a result of an allegedly traumatic birth wherein he experienced lack of oxygen to the brain, micro bleeding and meconium aspiration. The lawsuit claimed that the defendant provided negligent prenatal and delivery care by, among other things, failing to recognize and respond to fetal macrosomia and recommend cesarean section delivery prior to due date, failing to recognize and respond to breech presentation, negligently evaluating on the day of delivery, failing to timely deliver by C-section, failing to urgently come to the hospital and order a stat C-section, and negligently delaying the delivery.

$1,000,000 Settlement (New York): a newborn male, large for gestational age, weighting 11 pounds, allegedly suffered Meconium Aspiration Syndrome, resulting in brain damage, leading to developmental delays, including deficits in speech/language, cognitive and neurological function and motor control. The lawsuit claimed that the defendants failed to properly suction and perform chest physical therapy and failed to properly communicate, leading to a prolonged birthing process, fetal distress and a delayed C-section.

$9,610,475 Verdict (New Jersey): The baby was delivered by Cesarean section after presenting in the breach position, with symptoms of meconium aspiration, respiratory distress, gestational hypertension and brain damage, resulting in spastic quadriplegic cerebral palsy and cortical blindness. The plaintiffs contended the defendant doctors were negligent for failing to properly monitor the pregnancy and delaying diagnosis such that the fetus suffered prolonged and repeated episodes of hypoxia which increased the risk of the newborn developing meconium aspiration syndrome and hypoxic ischemic encephalopathy.

$1,100,000 Settlement (New York): An infant sustained perinatal hypoxic brain damage, meconium aspiration syndrome and chronic lung disease after his mother was provided with prenatal care by defendant. The defendant allegedly provided negligent prenatal care, negligently sent mother home one day prior to birth after a non reassuring obstetric sonogram was remarkable for severe oligohydramnios and intrauterine growth restriction was disregarded.

Contact Our Birth Injury Malpractice Lawyers

If your child was injury due to mismanagement of meconium aspiration, contact our national birth injury malpractice lawyers at 800-553-8082 or contact us online.