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International Journal of Pediatrics
Volume 2012, Article ID 359571, 7 pages
Review Article

Advances in the Management of Meconium Aspiration Syndrome

1Division of Neonatology, Department of Pediatrics, University of Calgary, Calgary, AB, Canada T2N 1N4
2Alberta Children's Hospital Research Institute for Child and Maternal Health, University of Calgary, Calgary, AB, Canada T2N 4N1
3Department of Pediatrics, Foothills Medical Centre, Rm C211 1403-29th Street NW, Calgary, AB, Canada T2N 2T9

Received 25 July 2011; Accepted 9 October 2011

Academic Editor: Mei-Jy Jeng

Copyright © 2012 Kamala Swarnam et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Meconium aspiration syndrome (MAS) is a common cause of severe respiratory distress in term infants, with an associated highly variable morbidity and mortality. MAS results from aspiration of meconium during intrauterine gasping or during the first few breaths. The pathophysiology of MAS is multifactorial and includes acute airway obstruction, surfactant dysfunction or inactivation, chemical pneumonitis with release of vasoconstrictive and inflammatory mediators, and persistent pulmonary hypertension of newborn (PPHN). This disorder can be life threatening, often complicated by respiratory failure, pulmonary air leaks, and PPHN. Approaches to the prevention of MAS have changed over time with collaboration between obstetricians and pediatricians forming the foundations for care. The use of surfactant and inhaled nitric oxide (iNO) has led to the decreased mortality and the need for extracorporeal membrane oxygenation (ECMO) use. In this paper, we review the current understanding of the pathophysiology and management of MAS.