Meconium release into the amniotic fluid/during birth | Child pitch (meconium)

Meconium release into the amniotic fluid/during birth

The amniotic fluid is usually clear or milky. However, if the baby’s amniotic fluid is released prematurely before or during birth, it is cloudy greenish to blackish in color. Reasons for the premature discharge of baby pitch are various stress situations to which the unborn child is exposed.

The most common causes are an oxygen deficiency (hypoxia) or insufficient blood supply (ischemia). In these situations there is a redistribution of the blood supply (centralization), whereby vital organs, such as the heart and brain, are better supplied with blood at the expense of the gastrointestinal tract. This results in an increasing intestinal movement and relaxation of the sphincter muscle as the disease progresses.

The meconium thus reaches the amniotic cavity and can be swallowed again together with the amniotic fluid. Risk factors for premature meconium loss include a difficult and prolonged birth, infection during the foetal period, mothers with diabetes or high blood pressure, as well as smoking, drugs or alcohol during pregnancy. The premature discharge of meconium into the amniotic fluid creates the risk of contaminated amniotic fluid being swallowed by the fetus.

Aspiration is the unintentional inhalation of body fluids or foreign bodies. Not swallowing as such, but the great danger of inhaling the meconium-containing amniotic fluid poses a threat to the child. Since the meconium is colonized by intestinal germs such as E. coli and enterococci, inhaling the meconium poses the risk of pneumonia for the newborn.

Under certain circumstances this can lead to blood poisoning.In up to four percent of the unborn babies whose amniotic fluid is contaminated with meconium, this reaches the lungs (meconium aspiration) through the windpipe by accidental inhalation. The resulting clinical picture is called meconium aspiration syndrome (MAS). Components of the child’s speech can cause severe damage to the lung tissue.

Acute respiratory distress can occur. The newborn baby appears apathetic, breathes heavily and has a greenish smear. Usually the baby must be intubated and ventilated as soon as possible.

Attempts are also made to aspirate the inhaled meconium. Long-term damage is caused by tissue changes in the lungs with over-inflation (emphysema). However, most newborns recover well, and in the long term no impaired lung function is observed in affected children.

There is only a slightly increased risk of lung infection in the first year of life. Premature loss of child pitch in the mother’s belly is not a rarity. It is estimated that 13% of all babies are born from amniotic fluid containing meconium.

Only about 5-12% of these develop a complication in the sense of a meconium aspiration syndrome MAS, whereby the polluted amniotic fluid is inhaled accidentally. Premature babies can also drop out of the baby, as this is formed very early in the pregnancy. However, premature babies before the 32nd week of pregnancy are not the classic risk group for premature meconium discharge into the amniotic fluid and are therefore rarely affected by its complications. Rather, “transferred” unborn babies are affected, i.e. those that have been in the mother’s belly for too long (over 42 weeks of pregnancy).