title: Management for neonatal aspiration syndrome caused by vernix caseosa.
abstract: OBJECTIVE
  To clarify resuscitation methods against the lethal vernix caseosa aspiration syndrome.
  
  
  METHODS
  A single case report with a literature review.
  
  
  RESULTS
  Our case report was associated with aspiration syndrome caused by an airway obstruction of vernix caseosa: a proteolipid biofilm synthesized by the fetus. A 23-year-old woman normally delivered a mature infant at term. The infantile oral cavity was filled with numerous aggregates of vernix caseosa. Two hours after his birth, the infant died from respiratory insufficiency. We discuss the difference between management of our case and the previously reported case.
  
  
  CONCLUSIONS
  Pregnant women with a diffuse pattern of high-level echoes in prenatal ultrasonography, suggesting the presence of massive vernix caseosa, should be transferred to a well-equipped institution that can administer inhaled nitric oxide and extracorporeal membrane oxygenation.
authors.affiliation: Department of Obstetrics and Gynecology, University of Fukui, Matsuoka-Cho, Yoshida-Gun, Fukui, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Nishijima
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Shukunami
authors.forename: Shuji
authors.initials: S
authors.lastname: Inoue
authors.forename: Fumikazu
authors.initials: F
authors.lastname: Kotsuji
mesh_terms: D000328:Adult; D000402:Airway Obstruction / Q000150:complications / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D001239:Inhalation; D007442:Intubation, Intratracheal; D008168:Lung / Q000473:pathology; D008297:Male; D011247:Pregnancy; D012131:Respiratory Insufficiency / Q000209:etiology; D019233:Retreatment; D013577:Syndrome; D014708:Vernix Caseosa