Abstract: In a recent paper published in your Journal, Dr. Koehler et al. showed that meconium stained amniotic fluid (MSAF) is associated with worse outcomes in infants born with gastroschisis [ [1] Koehler S.M. et al. Meconium-stained amniotic fluid as a predictor of poor outcomes in gastroschisis. J Pediatr Surg. 2018; 53: 1665-1668 Scopus (3) Google Scholar ]. Most probably this is the result of direct damage by meconium to eviscerated intestines. This is not surprising, considering the injury that meconium causes once it enters the airways, causing meconium aspiration syndrome (MAS) [ [2] Vain N.E. Batton D.G. Meconium "aspiration" (or respiratory distress associated with meconium-stained amniotic fluid?). Semin Fetal Neonatal Med. 2017; 22: 214-219 Abstract Full Text Full Text PDF Scopus (26) Google Scholar ]. The mechanisms of damage by meconium are not entirely understood, but there is a generally accepted understanding that it is capable of causing significant direct damage [ [3] Kopincova J. Calkovska A. Meconium-induced inflammation and surfactant inactivation: specifics of molecular mechanisms. Pediatr Res. 2016; 79: 514-521 Google Scholar ]. In its extreme, prolonged intestinal exposure to meconium could lead to 70% mortality, as was observed in fetal meconium peritonitis [ [4] Payne R.M. Nielsen A.M. Meconium peritonitis. Am Surg. 1962; 28: 224-231 PubMed Google Scholar ].
Publication Year: 2019
Publication Date: 2019-02-01
Language: en
Type: letter
Indexed In: ['crossref', 'pubmed']
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