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Meconium aspiration syndrome — RACP Paediatrics MCQ

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ModerateNeonatalMeconium aspiration syndromeRACP Paediatrics

A term neonate born through thick meconium develops respiratory distress within minutes of birth. CXR shows bilateral coarse irregular opacities with hyperinflation and a right pneumothorax. What is the most likely diagnosis?

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Correct answer: A — Meconium aspiration

Thick meconium at delivery with early respiratory distress, coarse bilateral infiltrates with hyperinflation and air leak (pneumothorax) is meconium aspiration syndrome. Current guidelines advise against routine tracheal suctioning of vigorous meconium-stained neonates. Management is supportive with mechanical ventilation if needed, surfactant for severe disease, and iNO for associated PPHN.

Reference: RCH Melbourne – 2023 – MAS CPG; ANZCOR – 2024