Clinical manifestations of meconium aspiration include which signs?

• A. Tachypnea, retractions, nasal flaring, grunting
• B. Hypotension and bradycardia
• C. Jaundice and hepatomegaly
• D. Seizures and lethargy

Answer: (A)

Meconium in the airways irritates and blocks tiny airways, causing chemical inflammation and air–flow obstruction. This leads to immediate respiratory distress with increased work of breathing. The hallmark signs are rapid breathing (tachypnea) and visible effort to breathe (retractions), along with nasal flaring as the infant tries to bring more air in, and expiratory grunting as a mechanism to keep tiny airways open and improve ventilation. Together, these reflect the airway level problems and V/Q mismatch typical of meconium aspiration.

Other options describe problems that are not the classic respiratory signs of MAS. Hypotension and bradycardia can occur in severe illness but are not the primary airway-related signs. Jaundice and hepatomegaly point to liver or hematologic issues, not MAS-specific respiratory distress. Seizures and lethargy are CNS signs that suggest hypoxic-ischemic injury or metabolic problems rather than the primary respiratory manifestations of MAS.