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36 - Meconium staining and the meconium aspiration syndrome

from Section 4 - Specific conditions associated with fetal and neonatal brain injury

Published online by Cambridge University Press:  12 January 2010

By
Thomas E. Wiswell
Edited by
David K. Stevenson ,
William E. Benitz ,
Philip Sunshine ,
Susan R. Hintz  and
Maurice L. Druzin
David K. Stevenson
Affiliation:
Stanford University School of Medicine, California
William E. Benitz
Affiliation:
Stanford University School of Medicine, California
Philip Sunshine
Affiliation:
Stanford University School of Medicine, California
Susan R. Hintz
Affiliation:
Stanford University School of Medicine, California
Maurice L. Druzin
Affiliation:
Stanford University School of Medicine, California
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Summary

Introduction

Meconium-stained amniotic fluid (MSAF) occurs in approximately 10–15% of all pregnancies. The presence of MSAF has been recognized as being associated with adverse fetal and neonatal outcomes for centuries. Aristotle gave the substance the name meconium-arion, meaning “opium-like.” This may have been because the philosopher believed it induced fetal sleep, recognizing fetal deaths and neonatal depression as being associated with meconium. Conversely, the name may have arisen because processed opium is a black, tarry substance resembling meconium. Obstetricians and pediatricians have long recognized the relationship of MSAF with stillborn infants, abnormal fetal heart-rate (FHR) tracings, neonatal encephalopathy, respiratory distress, and an abnormal neurologic outcome in some survivors. Nevertheless, the vast majority of infants born through MSAF do not have apparent antenatal, intrapartum, or postnatal problems. Thus we have somewhat limited ability to predict and prognosticate from the presence of MSAF. Healthcare providers should be appropriately concerned about both MSAF and meconium-stained neonates who subsequently develop respiratory distress, the meconium aspiration syndrome (MAS). Despite the frequent occurrence of MSAF and MAS, there remains a distinct paucity of literature describing the neurological development of either children born through MSAF or those with MAS.

Type
Chapter
Information
Fetal and Neonatal Brain Injury , pp. 409 - 418
Publisher: Cambridge University Press
Print publication year: 2009

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References

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