Monitoring
All infants with a history of MAS need to be followed up closely.
Various follow-up studies on infants who had undergone treatment with inspired nitric oxide (iNO) or extracorporeal membrane oxygenation (ECMO) have reported respiratory and neurological developmental disabilities.[70]
Infants who have received oxygen with continuous positive airway pressure or have been ventilated for some time must be followed up in a special follow-up clinic to assess both respiratory and neurological development at least once after discharge from the hospital. Further follow-up may be required.
Infants who have a history of severe perinatal asphyxia, severe hypoxia after birth requiring high ventilatory settings, iNO therapy, or ECMO should be followed in both the neurodevelopmental clinic and the pulmonary clinic.
Tests that may be performed include oxygenation, pulmonary functions, neurological development, motor development, and mental development. Chest x-ray and brain imaging are indicated in the presence of abnormal respiratory findings, previous history of intrapartum and neonatal hypoxia, and prolonged ventilatory and oxygen support.
Some infants with severe birth asphyxia may also present with cerebral palsy and concomitant physical disabilities requiring physiotherapy. Others may have simple feeding problems requiring tube feeding or gastrostomy.
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