I have a question regarding meconium aspiration syndrome...

[smf0903]

Hi all! I am not sure this is the right forum, but I have a question. I have looked for an answer to this but can't find it (I forgot to ask the instructor last time I was in class!). When meconium is passed in utero, why does it lower the antimicrobial properties of the amniotic fluid? Since meconium is sterile, does it have something to do with the enzymes in meconium?

Thank you :)

[Esme12, ASN, BSN, RN]

tell me....What is meconium....? even thought it is "sterile" it contains "bacteria" it is still "stool".

[smf0903]

But my question is, if the gut of a baby in utero contains no bacteria, therefore the meconium is sterile (I distinctly remember reading about its sterility because I was like whaaat? Sterile stool?! LOL), why/how does it affect the antimicrobial ability of amniotic fluid? It seems counter-intuitive to me so the only thing I could think of is that the enzymes are the culprit??

[Esme12, ASN, BSN, RN]

While it is "sterile" is is still an contaminant OB is not my thing. There has been some anecdotal evidence that it does contain bacteria....Is meconium from healthy newborns actually sterile?

It is considered a contanimant...Medscape: Medscape Access

In utero meconium passage results from neural stimulation of a mature GI tract and usually results from fetal hypoxic stress. As the fetus approaches term, the GI tract matures, and vagal stimulation from head or cord compression may cause peristalsis and relaxation of the rectal sphincter leading to meconium passage.

The effects of meconium in amniotic fluid are well documented. Meconium directly alters the amniotic fluid, reducing antibacterial activity and subsequently increasing the risk of perinatal bacterial infection. Additionally, meconium is irritating to fetal skin, thus increasing the incidence of erythema toxicum. However, the most severe complication of meconium passage in utero is aspiration of stained amniotic fluid before, during, and after birth. Aspiration induces hypoxia via 4 major pulmonary effects: airway obstruction, surfactant dysfunction, chemical pneumonitis, and pulmonary hypertension.

Medscape has a great explanation of this...you have to register but it is free.

exactly why or how....I think I will move this to where you can get help.

[NicuGal, MSN, RN]

It can cause a pneumonia or pneumotitis

[NicuGal, MSN, RN]

Where did the rest of my post go lol . Anywho, it is a contamination in the sense if it shouldn't be there. As Esme said and the article stated, pneumonia and PPHN are the two things we see most often with meconium kids. The really aren't septic but the end result to their lungs can take some time to resolve.

[meanmaryjean, DNP, RN]

Interesting question. Hmmmm...... I'm wondering if the meconium 'carries' bacteria from the birth canal and due to its stickiness, gives the bacteria more time to take hold?

[CountyRat]

It is considered a contanimant...Medscape: Medscape Access

Medscape has a great explanation of this...you have to register but it is free.

I think that Esme's post nails it (as usual). The pulmonary pathology is not pneumonia, it is chemical pneumonitis. Different critter, though a newborn with chemical pneumonitis is certainly at increased risk for bacterial pneumonia after birth.

[smf0903]

Thank you all for replying! I appreciate it :) I get a question in my head and then have to (HAVE to) track down the answer! So thank you for the help

[CountyRat]

Thank you all for replying! I appreciate it :) I get a question in my head and then have to (HAVE to) track down the answer! So thank you for the help

Don't EVER lose that insatiable curiosity. It will enrich your life tremendously. (And, oh by the way, it will make you a better nurse, too.)

[smf0903]

Thanks CountyRat! I drive people nuts in lecture with my questions LOL It always amazes me that other students don't ask questions...