![]() ![]() Most babies who are born in a poor condition do not have meconium stained liquor. ![]() In summary, it is important to remember that: In addition, thick meconium rather than thin meconium is associated with complications. An abnormal heart rate is a better predictor of fetal distress and an abnormal heart rate + meconium may provide an even better indication that a baby may be in trouble. Meconium alone cannot be relied on as an indication of fetal distress: “… meconium passage, in the absence of other signs of fetal distress, is not a sign of hypoxia…”( Unsworth & Vause 2010). There are also other theories about meconium in pregnancy – that the baby continually passes it – but I think this post is confusing enough without wading into them (see the key articles for further information). Indeed, in ‘animal models’ the theory that hypoxia results in meconium has found to be incorrect. However, fetal distress can be present without meconium, and meconium can be present without fetal distress.īear in mind these are theories and there is no evidence to support them. The theory is that intestinal ischaemia (lack of oxygen) relaxes the anal sphincter and increases gastrointestinal peristalsis. However, the exact relationship between fetal distress and meconium stained liquor is uncertain. This may be due to increased movement of fluids through the baby’s bowel caused by bile acids. Intrahepatic cholestasis of pregnancy often causes the baby to pass thin meconium during pregnancy.If the baby is in a breech position, compression of the abdomen as their bottom moves through the vagina usually squeezes out meconium.It may be why a lot of babies pass meconium as their head is compressed during the last minutes of birth and then arrive with a trail of poop behind them. This is a normal physiological response and can happen without fetal distress. a vagally mediated gastrointestinal peristalsis. The umbilical cord or head is being compressed (during labour) ie.This is the most common reason – 15-20% of term babies and 30-40% of post-term babies will have passed meconium before birth. The digestive system has reached maturity and the intestine has begun working ie.There are five reasons (theoretically) that a baby may open their bowels before birth: Meconium is a mixture of mostly water (70-80%) and a number of other interesting ingredients (amniotic fluid, intestinal epithelial cells, lanugo, etc.). Around 15-20% of babies are born with meconium stained liquor. Both articles agree that there is very little known about meconium and whether it is a problem at all. One in an obstetric journal ( Unsworth & Vause 2010) and the other in a midwifery journal ( Powell 2013). This post is mostly based on two journal articles. ![]() Indeed, many of the interventions implemented because of the meconium are more likely cause complications than the meconium itself. This is a lot of fuss for a bit of poop which in the vast majority of cases is not a problem. In some hospitals the baby will be taken away from their mother to be observed in a nursery. In the first 24 hours after birth the baby will be disturbed regularly to have their temperature, breathing and heart rate assessed. Once born, the baby is likely to have their umbilical cord cut prematurely and be given to a paediatrician who may also suction the baby’s airways. As the baby is being born they may be subjected to airway suctioning which can cause a vagal response (heart rate deceleration) and difficulties with breastfeeding. Time limits for labour may be tightened up further resulting in induction or augmentation, which increases the chance of fetal distress and for first time mothers, c-section. A CTG machine will often be strapped onto the woman reducing her ability to move and increasing her chance of having a c-section or instrumental birth. ![]() When meconium is noticed in amniotic fluid during labour it often initiates a cascade of intervention. ![]()
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