Surfactant therapy for meconium aspiration syndrome in Dr. Soetomo General Hospital – A case series

INTRODUCTION: Meconium staining of amniotic fluid (MSAF) is a natural phenomenon in pregnant mothers and their fetuses. MSAF may lead to developing Meconium Aspiration Syndrome (MAS). Surfactant replacement therapy has recently emerged as a therapy in MAS, but no guideline outlines how to administer it properly.
CASE PRESENTATION: We present two-term neonates with severe MAS cases focusing on the bolus surfactant replacement therapy. The first baby was given surfactant at 23 hours after birth and the second baby at 8 hours after birth. We used Survanta (beractant) in the dose of 100 mg/kg BW in both cases. Clinical improvement was observed 24 hours after surfactant bolus administration with different clinical characteristics, treatment approaches, and outcomes.
CONCLUSION: In conclusion, therapeutic surfactant bolus in severe MAS may improve outcomes without significant adverse side effects.

Keywords
Meconium Aspiration Syndrome; Surfactant; Persistent Fetal Circulation Syndrome; Case Report