During a scheduled cesarean birth for a primigravid client with a fetus at 39 weeks’ gestation in a breech presentation, a neonatologist is present in the operating room because neonates born by cesarean birth tend to have an increased incidence of which problem?

During a scheduled cesarean birth for a primigravid client with a fetus at 39 weeks’ gestation in a breech presentation, a neonatologist is present in the operating room because neonates born by cesarean birth tend to have an increased incidence of which problem?

• A. Respiratory distress syndrome.
• B. Jaundice requiring phototherapy.
• C. Meconium aspiration syndrome.
• D. Congenital anomalies.

Answer: (C)

The situation centers on a newborn at term delivered by planned cesarean in breech position and the need to be prepared for a specific respiratory complication that can occur when meconium is present in the amniotic fluid. Meconium aspiration syndrome happens when meconium is inhaled into the lungs around the time of birth, causing airway blockage, chemical pneumonitis, and impaired gas exchange. This risk is heightened when there is fetal distress or breech presentation, where passing meconium may occur and be present in the amniotic fluid. Because MAS can rapidly compromise breathing at birth, having a neonatologist in the operating room ensures immediate suctioning, assessment, and support if aspiration occurs. Other choices—while neonatal jaundice, congenital anomalies, or general term-respiratory issues like transient tachypnea or RDS—can occur, they are not as specifically linked to the peripartum situation described. Jaundice is common but not delivery-mode specific; congenital anomalies are independent of how delivery occurs; and RDS or TTN are more about lung maturity and labor-associated hormonal changes, not as directly tied to meconium in this scenario.

The situation centers on a newborn at term delivered by planned cesarean in breech position and the need to be prepared for a specific respiratory complication that can occur when meconium is present in the amniotic fluid. Meconium aspiration syndrome happens when meconium is inhaled into the lungs around the time of birth, causing airway blockage, chemical pneumonitis, and impaired gas exchange. This risk is heightened when there is fetal distress or breech presentation, where passing meconium may occur and be present in the amniotic fluid. Because MAS can rapidly compromise breathing at birth, having a neonatologist in the operating room ensures immediate suctioning, assessment, and support if aspiration occurs.

Other choices—while neonatal jaundice, congenital anomalies, or general term-respiratory issues like transient tachypnea or RDS—can occur, they are not as specifically linked to the peripartum situation described. Jaundice is common but not delivery-mode specific; congenital anomalies are independent of how delivery occurs; and RDS or TTN are more about lung maturity and labor-associated hormonal changes, not as directly tied to meconium in this scenario.