Meconium is the name typically used to describe fetal fecal matter.
The passage of meconium by a baby prior to delivery has been associated with several potentially ominous conditions which require close and careful obstetrical monitoring and management.
It has been estimated that as many as 20 percent of all deliveries in the United States are complicated by the passage of meconium prior to delivery. In the vast majority of those cases, it is generally recognized that the pre-delivery passage of meconium by the baby is wholly without consequences.
However, in some cases, the pre-delivery passage of meconium may be a sign of potentially serious complications which can affect the well being of the baby.
For example, many researchers believe that the pre-delivery passage of meconium by a baby can be a response to hypoxia, or a reduction of oxygen to the baby. In such cases, the passage of meconium can act as a warning sign to the safe and careful obstetrician that the baby may be at risk for potentially serious neurologic injuries associated with hypoxia or asphyxia.
Thus, when confronted with evidence of meconium passage prior to delivery, a safe and careful obstetrician will closely monitor the baby’s status.
Such monitoring may include the use of ultrasonography, biophysical profile testing or the continuous electronic assessment of the baby’s heart rate.
The passage of meconium well prior to the time of delivery can cause meconium staining of the placenta, umbilical cord and even of the baby. Such meconium staining will frequently occur in post-term or post-dates pregnancies, wherein the baby is not delivered until well after term, that is after forty weeks of gestation.
Many researchers believe that prolonged exposure to meconium in utero can itself be potentially harmful to the baby, in that it can cause vasoconstriction in the umbilical cord which, in turn, can impede the flow of blood and oxygen to the baby.
In such cases, the reduction or impedance of umbilical cord blood flow will itself cause the baby to suffer hypoxia and increase the risk of permanent neurologic injury.
Additionally, it is believed by many researchers that the passage of meconium can facilitate the development of intrauterine infections.
Babies who pass meconium well prior to delivery are also at increased risk for aspirating the meconium into their lungs. This can result in a lung disease known as “Meconium Aspiration Syndrome.”
Even when meconium is passed by the baby into the amniotic fluid, it is generally not “inhaled” into the baby’s lungs since, prior to delivery, the baby’s gas exchange is mediated through the placenta.
However, when a baby suffers hypoxia or asphyxia prior to birth, a “gasping” reflex can occur which will result in the aspiration of the meconium laden amniotic fluid deep into the baby’s lungs.
Thus, the prevention of fetal hypoxia or asphyxia prior to delivery will, in many cases, decrease the risk of the development of meconium aspiration syndrome after birth.
In cases where the potential for the aspiration of meconium is recognized, the safe and careful obstetrician will thoroughly suction the baby’s mouth and trachea as soon as the baby’s head is delivered.
The presence of “thick” meconium is also associated with decreased amniotic fluid or oligohydramnios.
If thick meconium or oligohydramnios is assessed during the labor and delivery process, the safe and careful obstetrician will frequently utilize amnioinfusion. Amnioinfusion is a process in which fluid is administered into the uterine cavity to prevent umbilical cord compression and to lessen the risk of meconium aspiration.
The Law Firm of Dugan, Babij, Tolley & Kohler, LLC has extensive experience in representing families whose loved ones have died or been injured as a result of medical malpractice associated with the management of patients suffering from the effects of the passage of meconium prior to delivery, including meconium aspiration syndrome.
Since its inception in 1981, the Firm has recovered hundreds of millions of dollars for its clients by offering personalized legal representation in the complex areas of medical malpractice and birth trauma litigation.