Associate Professor of Obstetrics & Gynaecology. Medical Director, Neonatal, Women's & Community Specialist Services. Expert medico-legal reviews and reports.
Ten facts about Meconium-Stained Amniotic Fluid (MSAF), which occurs in up to 20% of term pregnancies: 1. The word ‘meconium’ is derived from the Greek word mekoni, which means ‘poppy juice’ or ‘opium-like’, referring to the belief that fetal exposure to meconium would lead to neonatal sleepiness or depression, a concept generally attributed to Aristotle. 2. Meconium is fetal colon contents, composed of water, skin cells, vernix and bowel secretions. 3. Although MSAF has been consistently linked to poorer outcomes for babies, most babies with MSAF are healthy at birth. Fetal heart rate monitoring (CTG) is recommended to confirm fetal safety. 4. Meconium is more common after 41 weeks due to the maturing gastrointestinal system. 5. MSAF is linked with intrauterine infections - chorioamnionitis - in both term and preterm babies. 6. Prolonged gestation, low oxygen and infection are only a small number of the associations, and for the remainder, the cause is unclear. 7. Thick meconium has a stronger link to admission to neonatal intensive care, ventilation and markers of low oxygen score at birth. 8. Meconium has been linked to a higher chance of maternal infection, post-partum haemorrhage and perineal wound breakdown. 9. Meconium - especially if it’s thick - can pass into a baby’s lungs, leading to airway blockage, chemical injury, lung disease and high blood pressure in the lung circulation. Routine suction of meconium at birth doesn’t reduce the likelihood of complications. Even with thick meconium, however, most babies are unaffected. 10. In the future, rapid testing of MSAF during labour may identify women and babies who could benefit from antibiotics. Routine antibiotic use is currently not recommended. Link to my OG Update and the review in the first comment.
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Associate Professor of Obstetrics & Gynaecology. Medical Director, Neonatal, Women's & Community Specialist Services. Expert medico-legal reviews and reports.
12moOG Update for April. Free subscription https://dannytucker.substack.com/p/og-update-for-april