{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T16:16:18Z","timestamp":1790266578910,"version":"4.1.0"},"reference-count":30,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T00:00:00Z","timestamp":1676332800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>MAS is a common cause of neonatal respiratory distress in term and post-term neonates. Meconium staining of the amniotic fluid occurs in about 10\u201313% of normal pregnancies, and about 4% of these infants develop respiratory distress. In the past, MAS was diagnosed mainly on the basis of history, clinical symptoms, and chest radiography. Several authors have addressed the ultrasonographic assessment of the most common respiratory patterns in neonates. In particular, MAS is characterised by a heterogeneous alveolointerstitial syndrome, subpleural abnormalities with multiple lung consolidations, characterised by a hepatisation aspect. We present six cases of infants with a clinical history of meconium-stained fluid who presented with respiratory distress at birth. Lung ultrasound allowed the diagnosis of MAS in all the studied cases, despite the mild clinical picture. All children had the same ultrasound pattern with diffuse and coalescing B-lines, pleural line anomalies, air bronchograms, and subpleural consolidations with irregular shapes. These patterns were distributed in different areas of the lungs. These signs are specific enough to distinguish between MAS and other causes of neonatal respiratory distress, allowing the clinician to optimise therapeutic management.<\/jats:p>","DOI":"10.3390\/diagnostics13040719","type":"journal-article","created":{"date-parts":[[2023,2,15]],"date-time":"2023-02-15T03:37:24Z","timestamp":1676432244000},"page":"719","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Lung Ultrasound in the Early Diagnosis and Management of the Mild Form of Meconium Aspiration Syndrome: A Case Report"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8914-8639","authenticated-orcid":false,"given":"Alessandro","family":"Perri","sequence":"first","affiliation":[{"name":"Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2991-2068","authenticated-orcid":false,"given":"Simona","family":"Fattore","sequence":"additional","affiliation":[{"name":"Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgia","family":"Prontera","sequence":"additional","affiliation":[{"name":"Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Letizia","family":"Patti","sequence":"additional","affiliation":[{"name":"Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7787-6751","authenticated-orcid":false,"given":"Annamaria","family":"Sbordone","sequence":"additional","affiliation":[{"name":"Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milena","family":"Tana","sequence":"additional","affiliation":[{"name":"Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0980-799X","authenticated-orcid":false,"given":"Vito","family":"D\u2019Andrea","sequence":"additional","affiliation":[{"name":"Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Vento","sequence":"additional","affiliation":[{"name":"Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,14]]},"reference":[{"key":"ref_1","unstructured":"American Academy of Pediatrics, and American Heart Association (2011). Textbook of Neonatal Resuscitation, American Academy of Pediatrics. [6th ed.]."},{"key":"ref_2","first-page":"771","article-title":"Frequency, causes and outcome of neonates with respiratory distress admitted to Neonatal Intensive Care Unit, National Institute of Child Health, Karachi","volume":"65","author":"Parkash","year":"2015","journal-title":"JPMA"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.prrv.2012.02.002","article-title":"Respiratory distress of the term newborn infant","volume":"14","author":"Edwards","year":"2013","journal-title":"Paediatr. Respir. Rev."},{"key":"ref_4","first-page":"994","article-title":"Newborn respiratory distress","volume":"92","author":"Hermansen","year":"2015","journal-title":"Am. Fam. Physician"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1542\/pir.35.10.417","article-title":"Respiratory distress in the newborn","volume":"35","author":"Reuter","year":"2014","journal-title":"Pediatr. Rev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1159\/000499361","article-title":"European Consensus Guidelines on the Management of Respiratory Distress Syndrome\u20142019 Update","volume":"115","author":"Sweet","year":"2019","journal-title":"Neonatology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"6506","DOI":"10.1016\/j.vaccine.2017.01.046","article-title":"Respiratory distress in the neonate: Case definition & guidelines for data collection, analysis, and presentation of maternal immunization safety data","volume":"35","author":"Sweet","year":"2017","journal-title":"Vaccine"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Olicker, A.L., Raffay, T.M., and Ryan, R.M. (2021). Neonatal Respiratory Distress Secondary to Meconium Aspiration Syndrome. Children, 8.","DOI":"10.3390\/children8030246"},{"key":"ref_9","unstructured":"Martin, R.J., Fanaroff, A.A., and Walsh, M.C. (2020). Fanaroff and Martin\u2019s Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant, Elsevier. [11th ed.]."},{"key":"ref_10","unstructured":"Fanaroff, A.A., Fanaroff, J.M., and Klaus, M.H. (2013). Klaus & Fanaroff\u2019s Care of the High-Risk Neonate, Elsevier\/Saunders. [6th ed.]."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1016\/S0140-6736(04)16852-9","article-title":"Oropharyngeal and nasopharyngeal suctioning of meconium- stained neonates before delivery of their shoulders: Multicentre, randomised controlled trial","volume":"364","author":"Vain","year":"2004","journal-title":"Lancet"},{"key":"ref_12","first-page":"162","article-title":"Meconium aspiration syndrome\u2014Unusual features","volume":"69","author":"Airede","year":"1992","journal-title":"East Afr. Med. J."},{"key":"ref_13","first-page":"41","article-title":"Meconium aspiration syndrome","volume":"19","author":"Moore","year":"2000","journal-title":"Neonatal Netw."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"355","DOI":"10.3233\/NPM-1372613","article-title":"Neonatal aspiration: Not just meconium","volume":"6","author":"Paviotti","year":"2013","journal-title":"J. Neonatal Perinat. Med."},{"key":"ref_15","unstructured":"Goldsmith, J., Karotkin, E., Suresh, G., and Keszler, M. (2017). Assisted Ventilation of the Neonate, Evidence-Based Approach to Newborn Respiratory Care, Elsevier. [6th ed.]."},{"key":"ref_16","first-page":"147","article-title":"The role of lung ultrasound in diagnosis of respiratory distress syndrome in newborn infants","volume":"24","author":"Liu","year":"2014","journal-title":"Iran. J. Pediatr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e197","DOI":"10.1097\/MD.0000000000000197","article-title":"Diagnosis of neonatal transient tachypnea and its differentiation from respiratory distress syndrome using lung ultrasound","volume":"93","author":"Liu","year":"2014","journal-title":"Medicine"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"S17","DOI":"10.1016\/S0378-3782(13)70006-9","article-title":"Lung ultrasound: Its role in neonatology and pediatrics","volume":"89","author":"Cattarossi","year":"2013","journal-title":"Early Hum. Dev."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1159\/000519712","article-title":"Use of Wireless Ultrasound Probe in Isolated Infants: A Case Report of Two SARS-CoV-2-Positive Mothers\u2019 Newborns","volume":"119","author":"Prontera","year":"2022","journal-title":"Neonatology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e5826","DOI":"10.1097\/MD.0000000000005826","article-title":"Routine application of lung ultrasonography in the neonatal intensive care unit","volume":"96","author":"Chen","year":"2017","journal-title":"Medicine"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"791664","DOI":"10.3389\/fped.2022.791664","article-title":"The Value of Lung Ultrasound Score in Neonatology","volume":"10","author":"Zong","year":"2022","journal-title":"Front. Pediatr."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1016\/j.arcped.2019.09.009","article-title":"Thoracic ultrasound accuracy for the investigation of initial neonatal respiratory distress","volume":"26","author":"Grimaldi","year":"2019","journal-title":"Arch. Pediatr. Organe Off. Soc. Fr. Pediatr."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"281","DOI":"10.3233\/NPM-181796","article-title":"Lung ultrasound in early diagnosis of neonatal transient tachypnea and its differentiation from other causes of neonatal respiratory distress","volume":"11","author":"Ibrahim","year":"2018","journal-title":"J. Neo-Natal-Perinat. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1177\/1742271X16689374","article-title":"Neonatal respiratory distress syndrome: Chest X-ray or lung ultrasound? A systematic review","volume":"25","author":"Hiles","year":"2017","journal-title":"Ultrasound"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1007\/s12098-016-2288-7","article-title":"Diagnostic Performance of Point of Care Ul-trasonography in Identifying the Etiology of Respiratory Distress in Neonates","volume":"84","author":"Rachuri","year":"2017","journal-title":"Indian J. Pediatr."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"83","DOI":"10.5114\/kitp.2015.50578","article-title":"Assessment of chest X-ray images in newborns with respiratory disorders","volume":"12","author":"Czarnecki","year":"2015","journal-title":"Kardiochirurgia Torakochirurgia Pol. = Pol. J. Cardio-Thorac. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"S41","DOI":"10.1016\/S0378-3782(14)50011-4","article-title":"Lung ultrasound findings in meconium aspiration syndrome","volume":"90","author":"Piastra","year":"2014","journal-title":"Early Hum. Dev."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1534","DOI":"10.1177\/0300060516663954","article-title":"Lung ultrasonography to diagnose meconium aspiration syndrome of the newborn","volume":"44","author":"Liu","year":"2016","journal-title":"J. Int. Med. Res."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1002\/jcu.22917","article-title":"Ultrasound-guided lung lavage for life-threatening bronchial obstruction due to meconium plug","volume":"49","author":"Centorrino","year":"2021","journal-title":"J. Clin. Ultrasound"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Monfredini, C., Cavallin, F., Villani, P.E., Paterlini, G., Allais, B., and Trevisanuto, D. (2021). Meconium Aspiration Syndrome: A Narrative Review. Children, 8.","DOI":"10.3390\/children8030230"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/13\/4\/719\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:35:22Z","timestamp":1760121322000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/13\/4\/719"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,14]]},"references-count":30,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["diagnostics13040719"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics13040719","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,14]]}}}