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The aetiology of meconium-stained amniotic fluid: pathologic hypoxia or physiologic foetal ripening? (Review)
L Monen1, T H Hasaart2, S M Kuppens2
1Department of Obstetrics and Gynaecology, Catharina Hospital Eindhoven, the Netherlands; Department of Medical Health Psychology, Tilburg University, Tilburg, the Netherlands.
Introduction:
Despite the many efforts to study the (patho)physiology of meconium release before delivery, it still remains an indistinct subject. Some studies have reported a relationship between hypoxia and MSAF, whilst others have not. The most common association found however, is between MSAF and the term of gestation.
Methods:
MEDLINE, EMBASE and the Cochrane library were electronically searched. Papers about the (patho)physiology of meconium-stained amniotic fluid in English were included. Papers about management strategies were excluded (see elsewhere this issue).
Results:
Different theories have been proposed including acute or chronic hypoxia, physiologic foetal ripening and peripartum infection.
Conclusion:
We suggest that meconium-stained amniotic fluid should be regarded as a symptom rather than a syndrome becoming more prevalent with increasing term and which might be associated with higher levels of infection or asphyxia.
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