What immediate management steps should be taken for a newborn diagnosed with Meconium Aspiration Syndrome?

Immediate management steps for a newborn diagnosed with Meconium Aspiration Syndrome (MAS):

• Ensure that resuscitation facilities and personnel are immediately available, and call for help if the baby requires resuscitation ¹.
• Do not suction the baby's upper airways (nasopharynx and oropharynx) before the birth of the shoulders and trunk, regardless of meconium presence ¹.
• If the baby has normal respiration, heart rate, and tone, do not suction the upper airways or intubate ¹.
• If the baby shows abnormal respiration, heart rate, or tone after any degree of meconium exposure, follow nationally accredited neonatal resuscitation guidelines, which may include intubation and suctioning of the trachea if indicated ¹.
• For babies with significant meconium but who appear healthy, closely observe them in a unit with immediate access to a neonatologist, with observations at 1 and 2 hours old, then every 2 hours until 12 hours old ¹.
• If signs of respiratory distress or instability develop (e.g., respiratory rate >60 breaths/min, grunting, heart rate <100 or >160 bpm, oxygen saturation <95%, central cyanosis), seek urgent neonatal assessment and consider transfer to a neonatal unit ¹.
• Provide respiratory support as needed, starting with air for basic resuscitation, escalating to oxygen supplementation or ventilation support according to the baby's clinical condition and following neonatal respiratory care guidelines ¹,².