Chronic intrauterine meconium aspiration causes fetal lung infarcts, lung rupture, and meconium embolism.

Abstract

Three neonates with chronic intrauterine meconium aspiration are reported. All had distinctive subpleural plate-infarcts of the lungs caused by meconium-induced vasoconstriction of peripheral preacinar arteries. These vessels showed plexogenic arteriopathy with medionecrosis and obliterative hyaline sclerosis. Organized thrombi and systemic-pulmonary arterial anastomoses were numerous. The infarcts contained inspissated meconium with a granulomatous reaction. In one case, lung rupture occurred, causing meconiumthorax and meconium embolism to hilar lymphatics and lymph nodes; this suggests that particulate meconium may enter the circulation. This fetus had rubella and probable acute twin-twin transfusion following the intrauterine death of the co-twin. The cause of the hypoxia that led to intrauterine passage of meconium in the other cases is unknown. Meconium-stained amniotic fluid was noted in only one case.

• Authors: M S Kearney
• Journal: Pediatric and developmental pathology : the official journal of the Society for Pediatric Pathology and the Paediatric Pathology Society (Pediatr Dev Pathol) Vol. 2 Issue 6 Pg. 544-51 ( 1999) ISSN: 1093-5266 [Print] United States
• PMID: 10508878 (Publication Type: Case Reports, Journal Article)

Topics

• Chronic Disease
• Diseases in Twins
• Fatal Outcome
• Female
• Humans
• Infant, Newborn
• Lung (blood supply, pathology)
• Male
• Meconium Aspiration Syndrome (complications, pathology)
• Pulmonary Embolism (etiology, pathology)
• Respiratory Distress Syndrome, Newborn (etiology, pathology)