A frequent complication of meconium aspiration is the development of

• A. Persistent pulmonary hypertension
• B. Acute respiratory distress syndrome
• C. Pulmonary edema
• D. Pneumothorax

Answer: (A)

Meconium aspiration commonly injures the lung and disrupts normal oxygenation, which sets the stage for persistent pulmonary hypertension. The aspirated meconium, along with the inflammatory response it triggers, blocks airways, damages surfactant, and causes alveolar collapse and V/Q mismatch. The resulting hypoxia and acidosis promote pulmonary vasoconstriction, increasing pulmonary vascular resistance. As a newborn’s circulation tries to adapt after birth, this elevated resistance can maintain right-to-left shunting through the foramen ovale and ductus arteriosus, leading to severe hypoxemia despite ventilation. This pattern—persistent pulmonary hypertension of the newborn—is the most characteristic and frequent complication of MAS. Other complications like ARDS, pulmonary edema, or pneumothorax can occur but are less typical as direct, frequent consequences of meconium aspiration.