CAN MECONIUM IN THE AMNIOTIC-FLUID INJURE THE FETAL BRAIN

Objective: To determine if meconium in the amniotic fluid (AF) can cau se cerebral palsy by stimulating umbilical and placental blood vessels to constrict. Methods: Brain injury patterns were analyzed in 43 chil dren whose exposure to meconium in the AF was their only identified ri sk for quadriplegic cerebral palsy. The times their injuries occurred were established by following lymphocyte counts in their blood after b irth. Results: All 43 had cerebral cortical and subcortical brain dama ge of the type produced by late gestational ischemia and hypoxemia. Th e time between the onset of injury and birth ranged from 2-38 hours. T he neonates were severely acidotic at birth when birth occurred within 12-14 hours after ischemia and hypoxemia began. Thereafter, the acido sis receded as the time between its start and birth increased, presuma bly because vasoconstriction had ended. Severe acidosis did not recede in nine children whose cerebral palsy was due to disorders that kept them hypoxemic until birth. Conclusion: Meconium in the AF may sometim es initiate vasoconstriction that leads to ischemic, hypoxemic cerebra l palsy.