Presentation
Term delivery at 40 weeks gestation with fetal distress, and meconium-stained fluid at birth.
Patient Data
Mildly hyperinflated lung fields. A normal but ill-defined cardiomediastinal contour. The ETT is infraclavicular at T1/T2 vertebral body level. There are overlying ECG leads. There is an overlying temperature lead. The umbilical arterial line is at mid-T6 vertebral body level. The umbilical venous line is likely within the right portal vein. There is no NG tube.
There are bilateral, asymmetric, patchy pulmonary opacities in keeping with meconium aspiration pneumonitis. There are no pleural effusions, no hemo or pneumothorax and no pneumomediastinum.
The bowel gas pattern is normal and appropriate for a newborn.
Case Discussion
In cases of meconium aspiration pneumonitis, a history of meconium-stained fluid at birth helps narrow down the potential causes of neonatal respiratory distress.
Infants are often term or post-term. In this instance, the gestation was 40 weeks at the time of delivery.
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