Document Detail


Inflammation of the lungs, umbilical cord and placenta associated with meconium passage in utero. Review of 123 autopsied cases.
MedLine Citation:
PMID:  9122031     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
It is uncertain how often the passage of meconium in utero is a response to some event causing fetal distress as opposed to being simply the physiologic functioning of a maturing intestinal tract. The extent to which meconium may produce injury or inflammation in pulmonary and placental tissues after intrauterine exposure is also unclear. This study was a retrospective review of 123 cases, 79 stillborn and 44 liveborn less than one month of age, autopsied at The Johns Hopkins Hospital, and showing histologic evidence of intrauterine meconium exposure by aspirated meconium or meconium macrophages in placental tissues. Of 55 cases with pulmonary inflammation, 13 (24%) had fetal pneumonia, 5 (9%) had postnatal bronchopneumonia, and 37 (67%) had inflammation secondary to meconium aspiration. There was inflammation of the umbilical cord in 31 (41%) of the 75 cases with available slides, 11 (15%) had funisitis associated with chorioamnionitis and 18 (58%) were secondary to meconium exposure. There were 19 cases with focal injury of cord vessels from meconium, two of which had cord ulceration. Inflammation of the membranes and chorionic plate was present in 24 (33%) of the 72 cases where it could be assessed, and was due to chorioamnionitis in 11 (46%) and to meconium in 13 (54%). In general, meconium-related inflammations was much less severe in the membranes than in the cord. There were 67 (54%) cases with definite or probable evidence of fetal distress. In 38 (48%) stillborns no cause of fetal death in utero was identified and in 18 (41%) liveborns there was no known prenatal problem. The results support the concept that meconium passage in utero may occur either as a response to fetal distress or as a physiologic process. Inflammation in the lung and placental tissues, and vascular injury in the umbilical cord may arise secondary to in utero exposure to meconium.
Authors:
A M Burgess; G M Hutchins
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pathology, research and practice     Volume:  192     ISSN:  0344-0338     ISO Abbreviation:  Pathol. Res. Pract.     Publication Date:  1996 Nov 
Date Detail:
Created Date:  1997-04-24     Completed Date:  1997-04-24     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  7806109     Medline TA:  Pathol Res Pract     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  1121-8     Citation Subset:  IM    
Affiliation:
Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
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MeSH Terms
Descriptor/Qualifier:
Female
Fetal Death / complications,  pathology
Fetus / metabolism*
Humans
Infant, Newborn
Inflammation
Meconium / metabolism*
Meconium Aspiration Syndrome / complications*
Placenta / blood supply,  pathology
Placenta Diseases / etiology*
Pneumonia / etiology*
Pregnancy
Retrospective Studies
Umbilical Cord / pathology*
Vascular Diseases / etiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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