Severe meconium aspiration syndrome is commonly associated with which complication?

• A. Metabolic alkalosis
• B. Left to right shunting
• C. Pneumothorax or pneumomediastinum
• D. Pulmonary edema

Answer: (A)

Severe meconium aspiration syndrome injures the lungs with inflammation, obstruction, and air trapping, which markedly increases intrapulmonary pressures. This fragile, overdistended lung environment is prone to alveolar rupture, leading to air leaks such as pneumothorax or pneumomediastinum. While MAS can cause pulmonary hypertension with right-to-left shunting and hypoxemia, the hallmark hazardous complication is the development of these air leaks. Metabolic alkalosis is not a typical consequence of MAS; instead, acid-base disturbances usually reflect hypoxemia and respiratory compromise rather than an alkalotic state. Left-to-right shunting is not characteristic of MAS, whereas air leaks are a more classic and frequent complication.