Mechanism(s) of in utero meconium passage

Lakshmanan, J.; Ross, Michael G.

doi:10.1038/jp.2008.144

Cited by 15 publications

(5 citation statements)

References 29 publications

(36 reference statements)

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“…The contents of the large bowel are colorless, or very light yellow in young fetuses, and colorless with a few specks of brown-green material between 12 and 23 weeks [98]. The mechanism of meconium passage in utero has been previously reviewed [4,5]. …”

Section: Discussionmentioning

confidence: 99%

Bacteria and endotoxin in meconium-stained amniotic fluid at term: could intra-amniotic infection cause meconium passage?

Romero

Yoon

Chaemsaithong

et al. 2013

The Journal of Maternal-Fetal & Neonatal Medicine

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Background Meconium-stained amniotic fluid (MSAF) is a common occurrence among women in spontaneous labor at term, and has been associated with adverse outcomes in both mother and neonate. MSAF is a risk factor for microbial invasion of the amniotic cavity (MIAC) and preterm birth among women with preterm labor and intact membranes. We now report the frequency of MIAC and the presence of bacterial endotoxin in the amniotic fluid of patients with MSAF at term. Materials and methods We conducted a cross-sectional study including women in presumed preterm labor because of uncertain dates who underwent amniocentesis, and were later determined to be at term (n=108). Patients were allocated into two groups: (1) MSAF (n=66) and (2) clear amniotic fluid (n=42). The presence of bacteria was determined by microbiologic techniques, and endotoxin was detected using the Limulus amebocyte lysate (LAL) gel clot assay. Statistical analyses were performed to test for normality and bivariate comparisons. Results Bacteria were more frequently present in patients with MSAF compared to those with clear amniotic fluid [19.6% (13/66) versus 4.7% (2/42); p<0.05]. The microorganisms were Gram-negative rods (n=7), Ureaplasma urealyticum (n=4), Gram-positive rods (n=2) and Mycoplasma hominis (n=1). The LAL gel clot assay was positive in 46.9% (31/66) of patients with MSAF, and in 4.7% (2/42) of those with clear amniotic fluid (p <0.001). After heat treatment, the frequency of a positive LAL gel clot assay remained higher in the MSAF group [18.1% (12/66) versus 2.3% (1/42), p<0.05]. Median amniotic fluid IL-6 concentration (ng/mL) was higher [1.3 (0.7–1.9) versus 0.6 (0.3–1.2), p=0.04], and median amniotic fluid glucose concentration (mg/dL) was lower [6 (0–8.9) versus 9 (7.4–12.6), p<0.001] in the MSAF group, than in those with clear amniotic fluid. Conclusion MSAF at term was associated with an increased incidence of MIAC. The index of suspicion for an infection-related process in postpartum women and their neonates should be increased in the presence of MSAF.

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Section: Discussionmentioning

confidence: 99%

Bacteria and endotoxin in meconium-stained amniotic fluid at term: could intra-amniotic infection cause meconium passage?

Romero

Yoon

Chaemsaithong

et al. 2013

The Journal of Maternal-Fetal & Neonatal Medicine

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“…Then, the fetal anal sphincter relaxed and gastrointestinal peristalsis increased, leading to the passage of meconium when umbilical vein oxygen saturations was below 30%. 25 In addition to the abovementioned short-term neonatal outcomes, recent studies have followed up on the long-term outcome in newborns. Fetal exposure to MSAF during labor and delivery may result in lower rates of long-term infectious-related hospitalizations, lower incidence of long-term infectious morbidity in the offspring, 4 lower rates of long‐term respiratory-related hospitalizations, 5 and an independent protective factor for dermatitis and skin rash-related hospitalizations throughout childhood and adolescence.…”

Section: Discussionmentioning

confidence: 99%

Once We Find Grade III Meconium Stained Amniotic Fluid, Must We Act as Early as Possible?

Zhu

Huang

Tang

et al. 2023

IJWH

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Background: Grade III meconium stained amniotic fluid (MSAF) is a common obstetric disease, and has the greatest impact on poor maternal and neonatal outcomes. Question or Hypothesis or Aim:There is no consensus on treatment, especially on the timing of delivery. Methods: We collected the medical records of 345 women who gave birth with grade III MSAF and analyzed the difference in baseline characteristics and maternal and neonatal outcomes relative to different labor stage, observation times in the first stage of labor, and the presence or absence of abnormal fetal heart rate (FHR) or thick amniotic fluid. Findings: Higher rate of cesarean section was observed when grade III MSAF was found in active labor. Intervention occurred at an observation time of 90-120 min, but there were no significant differences in maternal or neonatal outcomes shown when the observation time was greater than 3 or 4 hours. However, a higher rate of admission to the neonatal intensive care unit was demonstrated in cases with grade III MSAF with abnormal FHR either in the first or second stage of labor or in cases with thick MSAF in the second stage of labor. Discussion: Higher rate of composite adverse neonatal outcomes was found when secondary MSAF (a transition from clear AF to MSAF) was diagnosed >3 h before delivery. Conclusion:In the first stage of labor, an observation time of greater than 4 hours might be possible after grade III MSAF is found if the labor has progressed and is without abnormal FHR.

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“…MSAF is occured as a result of release of fetal colon material into the amniotic fluid. MSAF is seen in 12-16% of deliveries and this prevalence increases with gestational age [15]. It may indicate the physiologic process involving the mature fetal colon or acute/chronic hypoxic event, thereby making it a warning sign of a fetal compromise [16].…”

Section: Discussionmentioning

confidence: 99%

Cesarean Section At Full Cervical Dilatation: When Is It Troubling For Newborn?

Kokanali¹

2016

Ann Clin Anal Med

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Tam servikal dilatasyon durumunda yapılan sezaryen operasyonu sonrasındaki kötü perinatal sonuçlarla ilişkili potansiyel risk faktörlerini araştırmayı amaçladık. Gereç ve Yöntem: Tam servikal açıklıkta sezaryen olan 49 kadın bu retrospektif vaka-kontrol çalışmasına dahil edildi. Yenidoğan yoğun bakım ünitesine başvurunun kötü perinatal sonuç olarak tanımlandığı duruma sahip kadınlar vakalar olurken diğer kadınlar kontroller idi. Kötü perinatal sonuçla ilişkili olabilecek faktörler çoklu regresyon analizi ile incelendi. Kötü perinatal sonuçla ilişkili anlamlı faktör olarak bulunan durumlar varlığında tam servikal açıklıkta bekleme süresine ait eşik değerini belirlemek için ROC analizi uygulandı. Bulgular: 49 kadının 9 (18.4%) tanesi vaka grubunu oluştururken 40 (81.6%) tanesi kontrol grubunda idi. Çoklu regresyon analizinde persiste oksiput posterior pozisyonu kötü perinatal sonuç için anlamlı tek faktör olarak bulundu. Persiste oksiput posterior varlığında tam servikal açıklıkta 1.25 saat beklemenin ROC analizi sonucunda kötü perinatal sonucu öngörmede 75% duyarlılık ve 50% özgüllüge sahip olduğu bulundu. Tartışma: Persiste oksiput posterior pozisyon varlığı, tam servikal açıklıkta yapılan sezaryen durumunda kötü perinatal sonuç için risk faktörü olabilir. Tüm obstetrisyenler persiste oksiput posterior varlığında tam servikal açıklıkta beklenecek süre konusunda dikkatli olmalı ve 1 saatten fazla beklememeli.

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Mechanism(s) of in utero meconium passage

Cited by 15 publications

References 29 publications

Bacteria and endotoxin in meconium-stained amniotic fluid at term: could intra-amniotic infection cause meconium passage?

Bacteria and endotoxin in meconium-stained amniotic fluid at term: could intra-amniotic infection cause meconium passage?

Once We Find Grade III Meconium Stained Amniotic Fluid, Must We Act as Early as Possible?

Cesarean Section At Full Cervical Dilatation: When Is It Troubling For Newborn?

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