INTRODUCTION
Nature has provided the foetus with many protective mechanisms against many intra uterine hazards. One such protection is Amniotic fluid, the quantity varies , increasing with growing foetus, till term.
Amniotic fluid volume is related to gestational age.
It measures about 50 ml at 12 week of gestation about 400ml at 20 week of gestation and 1 litre at 36-38 week of gestation. At term it measure about 600-800ml.
In early pregnancy it is colourless and at term is become pale straw coloured.
Abnormal colours of fluid during pregnancy indicates different pathologies.
Meconium is a waste product, formed in foetal intestines, consisting :
Water
Desquamated cells from intestine and skin
Gastrointestinal mucin
Lanugo hair
Intestinal secretions
Meconium stained (green)
Golden colour
Greenish colour
Dark coloured
Dark brown coloured
Meconium is sterile, thick, black –
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Five pathways of exchange have been identified between the amniotic space and the surrounding tissues (see Figure 1). Production of AF is predominately accomplished by excretion of fetal urine (300 ml/kg fetal weight/day or 600 to 1200 ml/day near term) and the secretion of oral, nasal, tracheal, and pulmonary fluids (60 to 100 ml/kg fetal weight/day).(16) Fetal breathing movements contribute to the efflux of lung fluid into the AF, but about half of the effluent is swallowed rather than entering the AF. While volume changes with each fetal breath are small, < 100 beats/min): Use direct laryngoscopy, intubate, and suction the trachea immediately after delivery. Suction for no longer than 5 seconds. If no meconium is retrieved, do not repeat intubation and suction. If meconium is retrieved and no bradycardia is present, reintubate and suction. If the heart rate is low, administer positive pressure ventilation and consider suctioning again