[Meconium and postnatal neurologic handicaps].

OBJECTIVE

A review of meconium pathophysiology and its contribution to the incidence of postnatal neurological handicap.

DESIGN

Reviewed article.

SETTING

Department of Gynaecology and Obstetrics, Charles University and Faculty Hospital Plzen, Czech Republic.

SUBJECT AND METHOD: Meconium can be a cause of infant neurological handicap. Two main pathogenetic pathways are mentioned. 1. Meconium (and its components: bile acids) may have a direct vasoconstrictive effect on umbilical and placental vessels. This way still remains controversial. 2. Meconium as a possible cause of intraamniotic infection results in a release of fetal cytokines (TNF alpha, IL-1 beta, IL-6), which can damage myelinogenesis in periventricular white matter.

RESULTS

Meconium in premature labour is a higher risk factor compared to term delivery. 41% of premature infants were diagnosed as having CP when meconium was present compared to 10% in the same group with clear amniotic fluid. The incidence in term pregnancy with meconium present is 0.4% compared to 0.3% in a population without any obstetrical risk.

CONCLUSION

Ultrasonographically found periventricular leukomalacia is the most reliable sign of subsequent cerebral palsy or other neurological sequelae.