General Practice 2022

Mecônio: what é and main featuresístics

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Mecônio: what é and main featuresístics
Mecônio: what é and main featuresístics

“Meconium” is the name given to the first stools that are formed in the baby's intestine by bile s alts and other materials, it has a dark green color and is consistent and sticky.

The baby normally passes meconium in the first 24 to 36 hours after birth, stimulated by breastfeeding and this is important as it is a sign that the intestine is working well. Premature babies weighing less than 1500g, on the other hand, can eliminate meconium only after 48 hours of life.

However, in some cases, meconium elimination may not happen, take longer or happen before delivery, which can cause he alth problems for the baby such as pneumonia and intestinal paralysis.

Meconium characteristics

At first, meconium is dark green in color, thick and sticky. Around the 3rd to 4th day after birth, the consistency of the stool changes and becomes yellow-green in color and more liquid in consistency. At this stage, the baby starts to evacuate many times a day, especially if the diet is exclusively breast milk and on demand, that is, according to the newborn's wishes.

If the meconium is not passed within the first 24 to 36 hours, it may indicate that there is a problem with the baby and this is usually evaluated before discharge from the maternity unit, which only happens when the baby passes the first meconium.

Because meconium is not eliminated

Some situations during pregnancy, such as maternal diabetes, reduced oxygen to the baby and pregnancies over 42 weeks, can cause changes in the way meconium is eliminated by the baby. The main changes are:

Meconium aspiration

Decreased oxygen in the mother's belly can cause stress on the baby, which is known as fetal distress, causing meconium to be released before delivery. With this, the baby aspirates the meconium that is in the amniotic fluid, which is the fluid that surrounds the baby in the mother's belly. Understand better about fetal distress.

Aspiration of meconium by the baby is called meconium aspiration syndrome and usually the symptoms of inhalation are: rapid breathing, difficulty breathing, change in heartbeat, bluish discoloration of the skin, nails and mouth, nails long and blotchy and dry, flaky skin.

Some situations can cause meconium aspiration by the baby, such as pregnancy over 42 weeks, fetal distress, changes in the umbilical cord, mothers who smoke, who have diabetes, who have high blood pressure and babies who are born in childbirth cesarean.

Treatment: Most babies who aspirate meconium are treated and improve within 5 to 7 days.If the baby doesn't have trouble breathing, it can stay with the mother in the room. Depending on the severity of the meconium aspiration, the baby may need to be placed in an incubator, given oxygen therapy, treated with antibiotics and surfactant. In some cases, it is necessary to remove meconium from the babies' mouth, nose and lungs.

Sequelae: in some cases, meconium aspiration can lead to some sequelae such as pneumonia, decreased production of pulmonary surfactant, which is an important fluid for breathing, changes in on heart function and seizure.

Intestinal obstruction

When meconium is not passed or when the volume of meconium that is passed is very low, the baby's intestines may be obstructed. This change in the baby's bowel function can be caused by changes in the shape of the bowel or by difficulties in passing meconium.

When the baby's intestines are clogged, symptoms such as vomiting and swollen belly may appear, and the diagnosis can be made at two different times: still during pregnancy, through ultrasound, and after the baby is born, with radiography and biopsy, which is a test to assess the he alth of the body's tissues, in the baby's intestine.

Treatment: treatment of obstructed bowel is done after the baby is born and varies according to the assessment of the medical team, with the type and degree of bowel obstruction of the baby. When there is a change in the shape of the intestine, the treatment is done with surgery and if there are difficulties to eliminate the meconium, the baby's intestine is usually washed.

Sequelae: if there is a delay in diagnosing or treating the obstruction, there may be a loss of blood circulation in the baby's intestine and this can cause necrosis, which is the death of intestinal cells, being a serious situation.

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