What risk(s) is (are) there in positive-pressure ventilation before all meconium has been removed from the airways?

1. Forcing meconium into the lower airways
2. Pneumothorax
3. Triggering persistent pulmonary hypertension of the neonate (PPHN)
4. Triggering an asthma attack
a. 2
b. 3
c. 1, 2
d. 2, 3, 4

C
Positive-pressure ventilation can force any meconium from the upper airway down into the smaller airways. This can result in a "ball-valve" type of obstruction to exhalation. The trapped air can cause hyperinflation that can lead to a pneumothorax. PPHN and asthma are not linked to positive-pressure ventilation.