Meconium is the first stool of the neonate. It is composed of substances that are swallowed by the
fetus during „in utero“ period: epithelial cells, fetal hair, mucus, bile and water. Meconium aspiration syndrome
(MAS) is defined as respiratory distress that develops soon after birth, with radiologically confirmed aspiration
pneumonitis and presence of meconium stained amniotic fluid (MSAF). Prenatal asphyxia is the main cause of
MAS. The exact mechanism of intrauterine meconium evacuation remains unknown, but it is thought that fetal
distress and vagal stimulation are two possible causes. MSAF occurs in 5-22% of all pregnancies, and 1-12% of
infants born from MSAF develop MAS. If the child is vigorous after birth, there is no need for specific therapeutic
measures. However, if the neonate is depressed, it should be intubated and aspirated immediately. MAS is a
condition that can present only with mild respiratory symptoms but also, lethal outcomes can be seen despite all
treatment measures (mechanical ventilation + iNO + high frequency mechanical ventilation + ECMO).
We present a case of male neonate, born at our institution ( 39+6/7 weeks of gestation) and admitted to our
neonatal unit (level 2) with clinical signs of the MAS. The clinical picture was moderate and the radiologic findings
were impressive. He was given surfactant and respiratory support with nasal Continuous Positive Airway
Pressure (nCPAP) was started. We acchieved adequate oxygenation and ventilation, and the clinical picture
improved in the next few days. Using non-invasive respiratory support, we minimized the possibility for the
development of air leak syndromes and lung injury and preventing long term sequelae like cronic lung disease
and bronchopulmonary dysplasia
