Stools are dark blue, produced in the intestines of the fetus. After birth, babies will discharge stal feces in the first few days. However, due to the pressures that the baby undergoes before or during childbirth, it can cause the child to discharge sysioly in the uterus, mixed with amniotic fluid causing the child to inhale stools. This condition is called su stool inhalation syndrome (MAS) which is very dangerous.
1. Recognize signs of children inhaling stools
- Babies are born often of large stature, both people are covered with feces, the mouth is filled with amniotic fluid with feces, peeling skin.
- Withered umbilical cord
- Infants presenting with respiratory distress: rapid breathing, shortness of breath, moaning, cyanosis, apnea, puffy nose wings, chest recesses, rainbow chest
- Bradycardia, which may be less than 100 times per minute.
- Decreased muscle activity, weak movement
- Possible pregnancy malnutrition
- Children who inhale stools may be severely asphyxiated, clinically dead
- Listen to the lungs: there may be moist rales or bronchial rans
- X-ray of the lungs: unknown particles are concentrated around the pulmonary navel, gas retention in the lungs, collapse of the lungs and scattered emphysema.
- In some cases there is a thoracic gas overflow, there may be a pleural gas spill or a mediasced gas overflow.
- Biomedification: hypoxia, increased blood CO2, blood acidification.
- Severe cases may show signs of increased pulmonary artery pressure in the following hours.
Children who inhale amniotic fluid are saved without breathing oxygen for a long time at risk of chronic lung disease, increased airway sensitivity (prone to developing asthma, pneumonia) mental retreten, deafness.
2. Diagnostic test for amniotic fluid inhalation syndrome
- Blood formula
- Blood gas
- Electrolyzers, calcium, sugar, CRP
- X-rays of the heart and lungs.
- Cardiac ultrasound when pulmonary artery pressure is suspected.
3. Distinguish from other signs
Transient rapid breathing in newborns: common in babies 34-37 weeks gestation, the disease improves rapidly. Stool inhalation syndrome is common in children with a gestational age of more than 41 weeks or malnourished pregnancy, the disease is often severe.
- Acute respiratory distress syndrome :usually occurs in premature babies
- Pneumonia: some cases of pneumonia are somewhat difficult to distinguish from Stool Amniotic Inhalation Syndrome. However, in the case of children with pneumonia caused by inhalation of stools, amniotic fluid usually has stools.
- Early purple congenital heart disease: it is necessary to distinguish it from su stool inhalation syndrome by clinical examination, X-ray of the lungs and ultrasound of the heart.
- Pneumothorax: characterized by amniotic fluid without feces.
4. Handling children who inhale stools
According to some recommendations, children who inhale amniotic fluid are well-showed but must still be monitored closely in the first 24 hours, as severe manifestations can occur later in about 20-30% of cases. The child will be sucked out of the amniotic fluid in the pharynx and monitor the heart rate, breathing rate and oxygen in the blood …
When the child inhales amniotic fluid has severe signs such as respiratory failure, bradycardia <100 lần/phút, cử động yếu, giảm trương lực cơ… các bác sĩ sẽ tiến hành hút dịch ối phân su qua nội khí quản, mục đích làm sạch phân su trong đường hô hấp trên và dưới, làm thông thoáng đường thở và cho thở oxy. The child will continue treatment and follow-up at the intensive care unit, including:
- Breathe oxygen or ventilators if respiratory failure is severe.
- Surfactant replacement therapy.
- Antibiotics against infection.
- Treatment of pulmonary hypertension with specific methods.
- Respiratory physics.
- Monitoring and treating complications of pleural effusion, hospital infections …
5. How to prevent children from inhaling stools
High-risk pregnancies such as: delayed pregnancyin the uterus, old pregnancy, pre-meditis, high blood pressure, chronic cardi lung disease … should be carefully monitored during pregnancy and during childbirth.
When seeing that the amniotic fluid is dark blue, this is an early sign that the likelihood of the child inhaling rubber stools is very high, the mother should immediately notify the doctor to monitor the gestational heart rate, pregnancy failure and take early interventions, avoiding accidents.
Although inhalation of amniotic fluid in babies can lead to dangerous complications, the majority of cases are not serious. Monitoring the signs of child inhalation of stools carefully and timely treatment will help to limit the severe condition as well as the later symptoms.
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- Fetal stools: Things you may not know
- Infants inhaling stools: Handling and prevention
- Stool inhalation syndrome