Meconium Aspiration Syndrome Complicated by Persistent Pulmonary Hypertension of the Newborn: A Case Report

Abstract

Background: Meconium aspiration syndrome (MAS) is a significant cause of neonatal respiratory distress and is associated with considerable morbidity and mortality, particularly when complicated by persistent pulmonary hypertension of the newborn (PPHN). Early recognition and timely intervention are crucial for improving outcomes. Case Presentation: We report the case of a term male neonate born at 37 weeks of gestation with a birth weight of 2.9 kg, delivered by lower segment cesarean section in the presence of thick meconium-stained amniotic fluid. Although the infant cried immediately after birth, he developed respiratory distress and apnea episodes within the early postnatal period and was referred to a tertiary care center. On admission, the neonate was tachypneic with poor oxygen saturation. Laboratory investigations revealed an elevated C-reactive protein level, while other hematological parameters were within normal limits. Chest radiography demonstrated bilateral patchy pulmonary opacities with areas of hyperinflation, consistent with MAS. The clinical and radiological findings supported the diagnosis of MAS complicated by PPHN. Management and Outcome: The neonate was treated with oxygen support, mechanical ventilation, antibiotics, and general supportive care. Echocardiography confirmed PPHN, and appropriate heart and lung treatment was started. The baby gradually improved, was weaned off ventilatory support, and discharged in stable condition. Conclusion: This case highlights the importance of early imaging and comprehensive cardiopulmonary evaluation in diagnosing MAS complicated by PPHN. Prompt diagnosis and aggressive respiratory and supportive management can significantly improve clinical outcomes and reduce neonatal morbidity and mortality.