North American Registry of Midwives (NARM) Practice Exam

Which symptom is NOT associated with meconium aspiration syndrome?

1. Cyanosis

2. Grunting with exhale

3. Excessive crying

4. Nasal flaring

The correct answer is: Excessive crying

Meconium aspiration syndrome (MAS) occurs when meconium, the first stool of a newborn, is inhaled into the lungs around the time of delivery. This can lead to a host of respiratory issues due to the thick, sticky nature of meconium mixed with amniotic fluid, which can obstruct airways and cause inflammation. Cyanosis is often present in MAS as it indicates inadequate oxygenation, necessitating immediate medical attention. Grunting with exhalation is a sign of respiratory distress, as it indicates that the newborn is trying to keep the alveoli open to improve oxygen exchange. Nasal flaring is another indicator of respiratory distress, as infants will widen their nostrils in an effort to take in more air when they are struggling to breathe. Excessive crying, however, is not a typical symptom associated with meconium aspiration syndrome. While a newborn may cry for various reasons, such as hunger or discomfort, the severity of MAS usually leads to respiratory distress, which can cause the infant to be more lethargic or less responsive rather than excessively crying. Therefore, excess crying does not correlate with the more severe signs and symptoms typically observed in MAS cases.