Management of the Meconium-Stained Newborn

For infants with meconium-stained amniotic fluid, management has significantly changed over time. The goal of preventing meconium aspiration syndrome (MAS) and its complications led to the initial recommendations in the 1970s and 1980s based on biologic plausibility and nonrandomized studies. The incidence of MAS and mortality related to MAS has progressively declined since the 1970s, most likely because of obstetric practices that have decreased the incidence of birth beyond 41 weeks’ gestation. As the body of evidence evolved, these interventions were abandoned. The latest recommendations for management of MAS are based on multiple large randomized trials and are reflected in the 2015 American Heart Association guidelines.