RARE DISEASE
Meconium aspiration syndrome
Meconium aspiration syndrome
Meconium aspiration syndrome
Drug discovery
3
drugs
With orphan designations
Overview
Meconium Aspiration Syndrome (MAS) is a respiratory disorder in neonates caused by inhalation of meconium-stained amniotic fluid, leading to airway obstruction, surfactant inactivation, and chemical pneumonitis. It primarily affects term/post-term infants, often triggered by fetal distress. Complications include hypoxemia, pulmonary hypertension (PPHN), and pneumonia. Diagnosis relies on clinical signs (e.g., tachypnea, cyanosis) and chest X-ray findings [1][3][5][6].
Categories: rare respiratory diseases
Research Papers
842 drug discovery papers about Meconium aspiration syndrome, with 2 first-in-class and 4 next-in-class emerging drug candidates forecasted to outperform the average preclinical success rate. Recent publications:
842 drug discovery papers about Meconium aspiration syndrome, with 2 first-in-class and 4 next-in-class emerging drug candidates forecasted to outperform the average preclinical success rate. Recent publications:
2026-05-31 | Role of Intrapartum Amnioinfusion in Meconium Stained Liquor: A Prospective Study at a Secondary Care Hospital in a Resource-Limited Setting
Background: Meconium-stained amniotic fluid (MSAF) is a common obstetric complication associated with fetal distress, meconium aspiration syndrome (MAS), increased operative deliveries, and neonatal morbidity and mortality. In resource-limited settings, intrapartum amnioinfusion has been proposed as a simple and costeffective intervention to improve fetomaternal outcomes. Aim: To evaluate the role of intrapartum transcervical amnioinfusion in women with meconium-stained amniotic fluid and its effect on maternal and neonatal outcomes at a secondary care hospital. Materials and Methods: This prospective comparative study was conducted at Mansa Civil Hospital, a secondary care hospital, over a period of one year from April 2025 to April 2026. A total of 100 term pregnant women with meconium-stained liquor were included and divided into two groups. Group A consisted of 50 women who underwent transcervical amnioinfusion, while Group B included 50 women managed expectantly without amnioinfusion. Maternal and neonatal outcomes such as mode of delivery, amnioinfusion-to-delivery interval, Apgar score, neonatal resuscitation, NICU admission, incidence of MAS, and maternal complications were compared between the groups. Results: Normal vaginal delivery was higher in the amnioinfusion group (72%) compared to the control group (64%), while the cesarean section rate was lower in Group A (18%) than Group B (30%). Neonatal outcomes were comparatively better in the amnioinfusion group, with lower rates of neonatal resuscitation (28% vs 36%), NICU admissions (18% vs 26%), and MAS referrals (8% vs 12%). A higher proportion of neonates in Group A had favourable Apgar scores >7 at 1 minute (78% vs 70%). Maternal complications were minimal and manageable. Conclusion: Intrapartum transcervical amnioinfusion is a safe, simple, and effective intervention in cases of meconium-stained liquor. It reduces operative delivery rates and improves neonatal outcomes, making it particularly beneficial in resource-limited secondary care settings.
2026-05-24 | [Use of inhaled nitric oxide during neonatal transport - a review of seven years of experience].
The management of newborns with persistent pulmonary hypertension has critical importance. These infants require immediate on-site intensive care, which must be continued during transport until arrival at a tertiary regional center. Inhaled nitric oxide is an effective pulmonary vasodilator, and its use during transport may support the treatment of pulmonary hypertension and ensure adequate gas exchange until handover in the intensive care unit. Since March 2018, the Neonatal Transport Service of the Peter Cerny Foundation has been the only provider in Hungary to administer inhaled nitric oxide during neonatal transport. To evaluate the use of inhaled nitric oxide during definitive on-site management and neonatal transport. In this retrospective cohort study, we analyzed data from newborn infants born between March 2018 and March 2025 who were transported by the Neonatal Transport Service of the Peter Cerny Foundation and received inhaled nitric oxide therapy. 5 patients were excluded due to postnatal age over one week or postmenstrual age exceeding 46 weeks, and 3 additional patients were excluded because of incomplete ventilation data. A total of 41 cases were included in the analysis. The mean gestational age was 38 weeks (range: 28-41). The most common primary diagnosis was meconium aspiration syndrome (n = 19), followed by congenital diaphragmatic hernia (n = 7). Prior to transport, 21 infants (51%) received surfactant therapy. 8 transports originated from outside the service's primary catchment area. In 9 cases, inhaled nitric oxide therapy was initiated by the local care team; in the remaining cases, treatment was started by the neonatal transport team, in more than one-third of patients before 6 hours of life. In 24 cases (58%), infants were transported using high-frequency oscillatory ventilation. 14 newborns (43.7%) showed a response to inhaled nitric oxide, defined as at least a 20% reduction in oxygen requirement by the end of transport. Extracorporeal membrane oxygenation therapy was initiated after transport in 3 cases. The administration of inhaled nitric oxide during neonatal transport is feasible and safe, and provides effective support for the initiation and maintenance of definitive intensive care in critically ill newborns until transfer to a regional tertiary center. Orv Hetil. 2026; 167(21): 824-832.
2026-03-28 | Predictors of adverse neonatal outcomes in low-risk nulliparous women at term with meconium-stained amniotic fluid.
Meconium-stained amniotic fluid (MSAF) has been linked to adverse neonatal outcomes, but most evidence comes from heterogeneous cohorts that included multiparous and high-risk women. Nulliparous women without comorbidities are generally considered low risk, yet their outcomes in the presence of MSAF remain less well defined. This study aimed to identify predictors of adverse neonatal outcomes in low-risk nulliparous women at term with MSAF. A retrospective cohort study. Seven hundred sixty low-risk nulliparous women with documented MSAF at term delivery between March 2020 and July 2024. A tertiary, university-affiliated medical center. Obstetric and neonatal data were extracted from electronic medical records. Maternal, intrapartum, and neonatal characteristics were compared between women with and without an adverse neonatal outcome. The latter was defined as the presence of at least one of the following: a 5-min Apgar score < 7, umbilical artery pH < 7.15, admission to the neonatal intensive care unit, the need for invasive ventilation, meconium aspiration syndrome, or neonatal death. Multivariable logistic regression was performed to identify independent predictors of adverse outcome. Among women with adverse neonatal outcomes (59, 7.8%) compared to those without adverse outcomes, the mean delivery was earlier (39.3 ± 2.5 vs 40.0 ± 1.0 weeks, p < 0.001) and the mean birthweight lower (3171.8 ± 698.8 g vs 3328.7 ± 413.2 g, p = 0.009). Prolonged rupture of membranes > 18 h was more common (11.9% vs 3.0%, p = 0.004), as was chorioamnionitis (22.0% vs 10.6%, p = 0.012). Meconium thickness was greater (p = 0.049). In multivariable logistic regression, early term delivery (adjusted odds ratio (aOR) 3.63, 95% CI 1.76-7.51), prolonged rupture of membranes > 18 h (aOR 4.27, 95% CI 1.93-9.47), moderate meconium (aOR 2.46, 95% CI 1.29-4.69), thick meconium (aOR 4.67, 95% CI 2.00-10.91), and chorioamnionitis (aOR 2.74, 95% CI 1.52-4.93) were independent predictors of an adverse neonatal outcome. The retrospective single-center design and limited number of adverse neonatal events may restrict generalizability and preclude assessing risks for specific morbidities. Among low-risk nulliparous women with MSAF, early term delivery, prolonged rupture of membranes, greater meconium thickness, and chorioamnionitis were associated with adverse neonatal outcomes. These factors may assist in predicting risk and guiding intrapartum management, though validation in larger prospective studies is needed.
2026-05-31 | Role of Intrapartum Amnioinfusion in Meconium Stained Liquor: A Prospective Study at a Secondary Care Hospital in a Resource-Limited Setting
Background: Meconium-stained amniotic fluid (MSAF) is a common obstetric complication associated with fetal distress, meconium aspiration syndrome (MAS), increased operative deliveries, and neonatal morbidity and mortality. In resource-limited settings, intrapartum amnioinfusion has been proposed as a simple and costeffective intervention to improve fetomaternal outcomes. Aim: To evaluate the role of intrapartum transcervical amnioinfusion in women with meconium-stained amniotic fluid and its effect on maternal and neonatal outcomes at a secondary care hospital. Materials and Methods: This prospective comparative study was conducted at Mansa Civil Hospital, a secondary care hospital, over a period of one year from April 2025 to April 2026. A total of 100 term pregnant women with meconium-stained liquor were included and divided into two groups. Group A consisted of 50 women who underwent transcervical amnioinfusion, while Group B included 50 women managed expectantly without amnioinfusion. Maternal and neonatal outcomes such as mode of delivery, amnioinfusion-to-delivery interval, Apgar score, neonatal resuscitation, NICU admission, incidence of MAS, and maternal complications were compared between the groups. Results: Normal vaginal delivery was higher in the amnioinfusion group (72%) compared to the control group (64%), while the cesarean section rate was lower in Group A (18%) than Group B (30%). Neonatal outcomes were comparatively better in the amnioinfusion group, with lower rates of neonatal resuscitation (28% vs 36%), NICU admissions (18% vs 26%), and MAS referrals (8% vs 12%). A higher proportion of neonates in Group A had favourable Apgar scores >7 at 1 minute (78% vs 70%). Maternal complications were minimal and manageable. Conclusion: Intrapartum transcervical amnioinfusion is a safe, simple, and effective intervention in cases of meconium-stained liquor. It reduces operative delivery rates and improves neonatal outcomes, making it particularly beneficial in resource-limited secondary care settings.
2026-05-24 | [Use of inhaled nitric oxide during neonatal transport - a review of seven years of experience].
The management of newborns with persistent pulmonary hypertension has critical importance. These infants require immediate on-site intensive care, which must be continued during transport until arrival at a tertiary regional center. Inhaled nitric oxide is an effective pulmonary vasodilator, and its use during transport may support the treatment of pulmonary hypertension and ensure adequate gas exchange until handover in the intensive care unit. Since March 2018, the Neonatal Transport Service of the Peter Cerny Foundation has been the only provider in Hungary to administer inhaled nitric oxide during neonatal transport. To evaluate the use of inhaled nitric oxide during definitive on-site management and neonatal transport. In this retrospective cohort study, we analyzed data from newborn infants born between March 2018 and March 2025 who were transported by the Neonatal Transport Service of the Peter Cerny Foundation and received inhaled nitric oxide therapy. 5 patients were excluded due to postnatal age over one week or postmenstrual age exceeding 46 weeks, and 3 additional patients were excluded because of incomplete ventilation data. A total of 41 cases were included in the analysis. The mean gestational age was 38 weeks (range: 28-41). The most common primary diagnosis was meconium aspiration syndrome (n = 19), followed by congenital diaphragmatic hernia (n = 7). Prior to transport, 21 infants (51%) received surfactant therapy. 8 transports originated from outside the service's primary catchment area. In 9 cases, inhaled nitric oxide therapy was initiated by the local care team; in the remaining cases, treatment was started by the neonatal transport team, in more than one-third of patients before 6 hours of life. In 24 cases (58%), infants were transported using high-frequency oscillatory ventilation. 14 newborns (43.7%) showed a response to inhaled nitric oxide, defined as at least a 20% reduction in oxygen requirement by the end of transport. Extracorporeal membrane oxygenation therapy was initiated after transport in 3 cases. The administration of inhaled nitric oxide during neonatal transport is feasible and safe, and provides effective support for the initiation and maintenance of definitive intensive care in critically ill newborns until transfer to a regional tertiary center. Orv Hetil. 2026; 167(21): 824-832.
2026-03-28 | Predictors of adverse neonatal outcomes in low-risk nulliparous women at term with meconium-stained amniotic fluid.
Meconium-stained amniotic fluid (MSAF) has been linked to adverse neonatal outcomes, but most evidence comes from heterogeneous cohorts that included multiparous and high-risk women. Nulliparous women without comorbidities are generally considered low risk, yet their outcomes in the presence of MSAF remain less well defined. This study aimed to identify predictors of adverse neonatal outcomes in low-risk nulliparous women at term with MSAF. A retrospective cohort study. Seven hundred sixty low-risk nulliparous women with documented MSAF at term delivery between March 2020 and July 2024. A tertiary, university-affiliated medical center. Obstetric and neonatal data were extracted from electronic medical records. Maternal, intrapartum, and neonatal characteristics were compared between women with and without an adverse neonatal outcome. The latter was defined as the presence of at least one of the following: a 5-min Apgar score < 7, umbilical artery pH < 7.15, admission to the neonatal intensive care unit, the need for invasive ventilation, meconium aspiration syndrome, or neonatal death. Multivariable logistic regression was performed to identify independent predictors of adverse outcome. Among women with adverse neonatal outcomes (59, 7.8%) compared to those without adverse outcomes, the mean delivery was earlier (39.3 ± 2.5 vs 40.0 ± 1.0 weeks, p < 0.001) and the mean birthweight lower (3171.8 ± 698.8 g vs 3328.7 ± 413.2 g, p = 0.009). Prolonged rupture of membranes > 18 h was more common (11.9% vs 3.0%, p = 0.004), as was chorioamnionitis (22.0% vs 10.6%, p = 0.012). Meconium thickness was greater (p = 0.049). In multivariable logistic regression, early term delivery (adjusted odds ratio (aOR) 3.63, 95% CI 1.76-7.51), prolonged rupture of membranes > 18 h (aOR 4.27, 95% CI 1.93-9.47), moderate meconium (aOR 2.46, 95% CI 1.29-4.69), thick meconium (aOR 4.67, 95% CI 2.00-10.91), and chorioamnionitis (aOR 2.74, 95% CI 1.52-4.93) were independent predictors of an adverse neonatal outcome. The retrospective single-center design and limited number of adverse neonatal events may restrict generalizability and preclude assessing risks for specific morbidities. Among low-risk nulliparous women with MSAF, early term delivery, prolonged rupture of membranes, greater meconium thickness, and chorioamnionitis were associated with adverse neonatal outcomes. These factors may assist in predicting risk and guiding intrapartum management, though validation in larger prospective studies is needed.
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Drug Discovery Landscape
3 orphan drug designations for Meconium aspiration syndrome.
3 orphan drug designations for Meconium aspiration syndrome.
Drug | Therapy type | Regulator | Orphan designation | Approval | Sponsor |
|---|---|---|---|---|---|
Colfosceril palmitate, Palmitic acid, Sinapultide, Sodium 1-palmitoyl-2-oleoyl-sn-glycero-3-(phospho-rac-(1-glycerol)) [Surfaxin] | proteins | EMA | 2001-09-19 | — | [INACTIVE] Discovery Laboratories, Inc. |
Lucinactant | small molecules | FDA | 1996-07-30 | — | Windtree Therapeutics, Inc. |
Beractant | other | FDA | 1993-12-20 | — | Ross Laboratories |
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