Summary

• Defined as respiratory distress in the newborn due to the presence of meconium in the trachea.
• Infants born through meconium-stained amniotic fluid are at risk of developing meconium aspiration syndrome, particularly in the presence of maternal and fetal risk factors.
• Soon after birth, infants present with respiratory distress (tachypnoea, chest retractions, and hypoxia). Some may be asymptomatic and apparently vigorous at birth, and develop severe respiratory distress hours later. Signs of post-maturity, a strong risk factor, include green/yellow-coloured skin; long, stained nails; and dry, scaling skin.
• Diagnosis is confirmed by CXR.
• Management is largely supportive. Infants should be monitored closely to ensure adequate oxygenation and ventilation.
• In the presence of persistent pulmonary hypertension, inhaled nitric oxide and extracorporeal membrane oxygenation therapy may be required.