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Meconium aspiration syndrome — MRCPCH FOP MCQ

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HardNeonatologyMeconium aspiration syndromeMRCPCH FOP

A post-term baby is born through thick meconium and develops respiratory distress immediately after birth. Oxygen saturation remains low, chest radiograph shows patchy infiltrates with hyperinflation and there is no maternal fever. What is the most likely diagnosis?

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Correct answer: B — Meconium aspiration syndrome

Respiratory distress after thick meconium exposure with patchy infiltrates and hyperinflation suggests meconium aspiration syndrome. Respiratory distress syndrome is more typical in preterm babies and causes low lung volumes. Congenital diaphragmatic hernia would show bowel loops in the chest and a scaphoid abdomen. The pearl is that meconium aspiration can be complicated by persistent pulmonary hypertension.

Reference: NLS/Resuscitation Council UK; NICE neonatal respiratory care