From: alanj@endeavor18.tek.com (Alan Jeddeloh)
Newsgroups: misc.kids
Subject: Re: Birth Story & moving with a newborn
Date: 15 Oct 92 17:46:42 GMT
Organization: Tektronix, Inc.

In article <1992Oct12.204347.8215@colorado.edu> mwalker@taimyr.Colorado.EDU (Marilyn Walker) writes:
>It is not just fetal distress that is the worry in this case.  Babies 
>continually swallow amniotic fluid, so if there is meconium in it, they
>swallow that too.  The big problem comes when they take their first breath.
>If they have swallowed the stuff, there is usually some still in the mouth,
>and it can cause serious consequences if inhaled.  That is why the OB did
>the extra-deep suction.  The baby may show no other signs of distress, but
>the birth is no longer truly low risk.  If it is inhaled, the baby could die
>(hate to say it but true) or wind up in NICU for a while.

(For those of you relatively new to this group, our first daughter, Emily,
was nearly stillborn.  She suffered profound brain damage, and is currently
living in a pediatric skilled nursing facility.  She is 27 months old, but 
still functions at about the newborn level.  She is microcephalic and suffers
from severe seizure disorder.  She is fed using a nasal/gastic tube.)

Emily's waters broke two weeks early (in the doctor's office), and were filled
with meconium. Her monitored heart rate when we arrived at the hospital was
fast (>170), monotonic, and were showing late decelerations.  We since read
in at least one text that the above combination is "a particularly ominous
sign".

After Emily's birth we consulted with a Perinatologist (high-risk specialist),
trying to find answers for what went wrong.  At the time, one of the theories
what that she had pinched her cord.

The perinatologist dismissed that theory, saying that what usually happens
is that is the baby pinches the cord, the baby "blacks out" and relaxes,
which restores the blood supply.  (This applies prior to labor.  If the cord
is compressed during contractions, the baby doesn't control the events).

Prior to blacking out the baby may move his(her) bowels, resulting in meconium
in the fluid, and also may make "gasping" actions, which can draw the meconium
into the lungs.  He also noted that a pinched cord usually results in a very
slow heart rate.  A very fast heart rate usually indicates poor oxygenation.

The baby may pinch her(his) cord several weeks prior to birth, which can result
in meconium in the waters but an otherwise health baby, provided that they
don't aspirate a lot of the meconium.

There are two major dangers from meconium aspiration.  The first is that the
meconium can physically block the lungs.  If not removed quickly, the baby can
suffocate.  Meconium is thick and sticky, and is very difficult to get out
of the lungs.  There is a child in the same nursing facility as Emily that this
happened to.  He suffered very severe brain damage because they simply couldn't
get the meconium out of his lungs in time.

The second danger is from mechanical pneumonia.  Lungs don't like any
foreign matter in them.  The meconium irritate the tissues, which swell and
and the lungs accumulate fluids.  (NOTE: this form of pneumonia is NOT caused
by any bacteria or virus.)  This is a very grave, life-threatening condition
in newborns.  After Emily was born, she was transferred to a NICU (her APGARs
were 1 and 2).  The initial greatest worry they had with her was that she
would develop pneumonia.  (As it turned out, she surprized them by not
developing pneumonia, but that may have been influenced by the fact that she
had to be put on a mechanical respirator later that night.  We did not learn
the full extent of her real injuries until she was three days old.)

--
    Alan Jeddeloh      W:(503) 685-2991  H:(503) 292-9740
    Tektronix, Inc.  D/S 60-850; PO Box 1000; Wilsonville, OR 97070
    Alan.Jeddeloh@tek.com          My family does not value George Bush
    You can put the children to bed, but you can't make them sleep!