Meconium exposure in gastroschisis

In a recent paper published in your Journal, Dr. Koehler et al. showed that meconium stained amniotic fluid (MSAF) is associated with worse outcomes in infants born with gastroschisis [1]. Most probably this is the result of direct damage by meconium to eviscerated intestines. This is not surprising, considering the injury that meconium causes once it enters the airways, causing meconium aspiration syndrome (MAS) [2]. The mechanisms of damage by meconium are not entirely understood, but there is a generally accepted understanding that it is capable of causing significant direct damage [3].