<i>In‐utero</i> defecation between weeks 14 and 22 of gestation: stools are whitish

Cajal, Carlos López Ramón y; Martínez, R. Ocampo

doi:10.1002/uog.239

Cited by 11 publications

(6 citation statements)

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“…In a different study, Lopez and Ocampo reported performing amniocentesis after defecation had been documented by examining the anus for 10–15 minutes in 70 fetuses between 14 and 22 weeks of gestation [110]. All samples of amniotic fluid were clear, but contained a whitish material, which was interpreted as representing fetal stool [110]. The authors reported that the amniotic fluid was clear because fetal intestinal content is not green in color at this gestational age window [110].…”

Section: Discussionmentioning

confidence: 99%

“…All samples of amniotic fluid were clear, but contained a whitish material, which was interpreted as representing fetal stool [110]. The authors reported that the amniotic fluid was clear because fetal intestinal content is not green in color at this gestational age window [110]. An unsettled issue is whether amniotic fluid (and the pellet) obtained shortly after defecation in the third trimester would also be clear in the absence of pathology (i.e.…”

Section: Discussionmentioning

confidence: 99%

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Bacteria and endotoxin in meconium-stained amniotic fluid at term: could intra-amniotic infection cause meconium passage?

Romero

Yoon

Chaemsaithong

et al. 2013

The Journal of Maternal-Fetal & Neonatal Medicine

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Background Meconium-stained amniotic fluid (MSAF) is a common occurrence among women in spontaneous labor at term, and has been associated with adverse outcomes in both mother and neonate. MSAF is a risk factor for microbial invasion of the amniotic cavity (MIAC) and preterm birth among women with preterm labor and intact membranes. We now report the frequency of MIAC and the presence of bacterial endotoxin in the amniotic fluid of patients with MSAF at term. Materials and methods We conducted a cross-sectional study including women in presumed preterm labor because of uncertain dates who underwent amniocentesis, and were later determined to be at term (n=108). Patients were allocated into two groups: (1) MSAF (n=66) and (2) clear amniotic fluid (n=42). The presence of bacteria was determined by microbiologic techniques, and endotoxin was detected using the Limulus amebocyte lysate (LAL) gel clot assay. Statistical analyses were performed to test for normality and bivariate comparisons. Results Bacteria were more frequently present in patients with MSAF compared to those with clear amniotic fluid [19.6% (13/66) versus 4.7% (2/42); p<0.05]. The microorganisms were Gram-negative rods (n=7), Ureaplasma urealyticum (n=4), Gram-positive rods (n=2) and Mycoplasma hominis (n=1). The LAL gel clot assay was positive in 46.9% (31/66) of patients with MSAF, and in 4.7% (2/42) of those with clear amniotic fluid (p <0.001). After heat treatment, the frequency of a positive LAL gel clot assay remained higher in the MSAF group [18.1% (12/66) versus 2.3% (1/42), p<0.05]. Median amniotic fluid IL-6 concentration (ng/mL) was higher [1.3 (0.7–1.9) versus 0.6 (0.3–1.2), p=0.04], and median amniotic fluid glucose concentration (mg/dL) was lower [6 (0–8.9) versus 9 (7.4–12.6), p<0.001] in the MSAF group, than in those with clear amniotic fluid. Conclusion MSAF at term was associated with an increased incidence of MIAC. The index of suspicion for an infection-related process in postpartum women and their neonates should be increased in the presence of MSAF.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Bacteria and endotoxin in meconium-stained amniotic fluid at term: could intra-amniotic infection cause meconium passage?

Romero

Yoon

Chaemsaithong

et al. 2013

The Journal of Maternal-Fetal & Neonatal Medicine

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“…На ранніх термінах вагітності вміст товстої кишки плода безбарвний або світло-жовтого кольору. У проміжку 12-23 тижнів серед безбарвного вмісту з'являються невеличкі фрагменти коричнево-зеленого кольору [4,15,16]. Раніше вважалось, що дефекація у плода до 24 тижня не здійснюється, оскільки в даний проміжок часу анус відкритий, а сфінктер не функціонує.…”

Section: вступunclassified

“…Навколоплідні води, забруднені меконієм, діагностуються на підставі вилиття амніотичної рідини зеленуватого кольору, однак результати ультразвукових досліджень, проведених в 2004 році [16] у 70 плодів з терміном гестації 14-22 тижні, які складалися з реєстрації дефекації плода та наявності меконію в навколоплідних водах, що виділяється після дефекації, а також проведення амніоцентезу для відбору матеріалу, показали, що у всіх досліджуваних плодів зразки амніотичної рідини були прозорими, а матеріал, який виділявся під час дефекації плода, завжди мав білуватий колір. У вагітних, які брали участь у дослідженні, під час пологів спостерігалося вилиття чистих і прозорих навколоплідних вод.…”

Section: вступunclassified

The Influence of Perinatal Risk Factors on the Development of Meconium Aspiration Syndrome in Newborn: Important in the Routine Practice of Doctor-Neonatologist

Kiselova¹,

Komar²

2022

Neonatol. hìr. perinat. med.

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The article summarizes the data on known risk factors for meconium aspiration syndrome (MAS) and those that continue to be studied to increase the effectiveness of the organization and provision of primary resuscitation for newly born, intensive care fornewborns with MAS, prevention of aspiration pneumonia and complications of MAS, including early and late neonatal sepsis. MAS hasnot lost its relevance in recent years, despite studies of this problem on all continents and in almost every country in the world, which is associated with a high incidence of MAS, aspiration pneumonia, persistent pulmonary hypertension, and pneumothorax. The frequency of meconium in amniotic fluid is from 10 to 24%, and the implementation of meconium aspiration syndrome occurs in 3-12% of cases. MAS increases the frequency of antenatal, intranatal fetal death, as well as neonatal mortality to 4.2% in the case of severe meconiumaspiration. Despite the scientifically proven link between the occurrence of meconium amniotic fluid and individual factors, includingpregnancy, infection and hypoxia, which play a key role in the development of MAS, the degree of influence of these factors at differentstages of pregnancy is still being studied. A study of the effect of hypoxia and infection on the imbalance between fetal defecation,urination, swallowing, respiratory tract secretion and amniotic fluid clearance. The differences between the value of physiological intrauterine defecation and pathological discharge of meconium in utero against the background of the infectious process in the mother (microbial colonization of the amniotic cavity funisitis), and fetal distress are shown. The role of delayed pregnancy, infection, andhypoxia during pregnancy in the development of MAS is emphasized, with an emphasis on the chronic course of these processes. It waspointed out that gestational age over 41 weeks cannot be considered a primary factor, in the risk of developing MAS, and the fact that body weight at birth is also important in the appearance of amniotic fluid contaminated with meconium and the development of MAS. If a pregnant woman has a microbial invasion of the amniotic cavity: chorioamnionitis or funisitis, the development of MAS is possible in a child born prematurely. Emphasized diagnostic value of intrauterine infection - a risk factor for MAS due to an increase in the normof several inflammatory mediators identified in umbilical cord blood. The influence of circulatory disorders occurring in utero under theinfluence of stress and shock factors (functional disorders in the mother-placenta-fetus system, hypertension, late hestosis in the mother,dehydration, infection, metabolic disorders, bad habits). The additional focus of neonatologists to ensure objective monitoring of thecondition of the fetus in maternity hospitals during the briefing, predicting the course of MAS will be insufficient justification for theindications for the use of oxytocin. Timely detection of new risk factors for MAS, the addition of importance in the development of MASwill help to improve and timely update birth protocols, in the presence of amniotic fluid contaminated with meconium, resuscitation andpost-resuscitation care for newborns, optimize clinical routes.

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“…Approximately 10-20% of the proteins contained in the amniotic fluid originate from the fetal intestine [4], and macrophages with meconium pigment have been observed in placental membranes without gross meconial staining of the placenta or umbilical cord [5]. Strong evidence has also been provided that intrauterine defecation is a normal process [6][7][8][9][10]. Using ultrasound, we have shown that it is a physiological process that occurs throughout gestation [9], and we have reported our observations of whitish fetal stools until week 22, which was against the traditional view that they are pigmented macroscopically.…”

Section: Introductionmentioning

confidence: 99%

New insights into intrauterine defecation

Cajal

2005

The Ultrasound Review of Obstetrics & Gynecology

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Objectives. To present two-and four-dimensional ultrasound illustrations of fetal defecation and formulate a hypothesis for the determinants of fetal stools color. Materials and methods. We studied 305 fetal anuses between 14 and 41 weeks of gestation with ultrasound imaging. Fetuses <24 weeks of age undet^'ent macroscopic examination of their stools at the time of genetic amniocentesis. Among 20 amniotic fluid sediments collected, 10 were kept in test tubes exposed to air and light and 10 remained in dark and hermetically sealed test tubes.Results. At least one expulsion of rectal contents was observed in all cases studied. The collected stools were whitish except in one case, where the sample was greenish. The amniotic fluid sediment remained whitish when kept in a sealed tube, and became greenish when the test tube was open. Conclusions. Fetal defecation is a physiologic function. Stools are whitish in color. A fetus-dependent biochemical mechanism seems to promote the stool coloring.

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In‐utero defecation between weeks 14 and 22 of gestation: stools are whitish

Cited by 11 publications

References 4 publications

Bacteria and endotoxin in meconium-stained amniotic fluid at term: could intra-amniotic infection cause meconium passage?

Bacteria and endotoxin in meconium-stained amniotic fluid at term: could intra-amniotic infection cause meconium passage?

The Influence of Perinatal Risk Factors on the Development of Meconium Aspiration Syndrome in Newborn: Important in the Routine Practice of Doctor-Neonatologist

New insights into intrauterine defecation

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