Meconiumhoudend vruchtwater

Geschreven door Margot van Dijk
Gepubliceerd op 14 januari 2022

Als er sprake is van meconiumhoudend vruchtwater tijdens de baring, is het protocol om de zorg over te dragen naar de tweedelijn. Daar wordt de conditie van de baby gemonitord met een CTG en na de bevalling wordt de baby een aantal uur geobserveerd in het ziekenhuis. Als de weeën nog niet op gang zijn, is het gebruikelijk om de baring in te leiden.

Wat is de reden van dit beleid? Is meconiumhoudend vruchtwater altijd gevaarlijk? Waarom lozen sommige baby’s meconium voor de geboorte? Opvallend is dat veel richtlijnen (zowel in Nederland als in het buitenland) verouderd zijn en gebruik maken van oude onderzoeken van meer dan 15 jaar oud. In dit artikel wordt meconiumhoudend vruchtwater en het beleid onder de loep genomen, waarbij zoveel mogelijk ook recent onderzoek wordt gebruikt.

Alfirevic, Z., Devane, D., & Gyte, G. M. (2006). Continuous cardiotocography (CTG) as a form of electronic fetal monitoring (EFM) for fetal assessment during labour. The Cochrane database of systematic reviews, (3), CD006066. https://doi.org/10.1002/14651858.CD006066

Balchin, I., Whittaker, J. C., Lamont, R. F., & Steer, P. J. (2011). Maternal and fetal characteristics associated with meconium-stained amniotic fluid. Obstetrics and gynecology, 117(4), 828–835. https://doi.org/10.1097/AOG.0b013e3182117a26

Beligere, N., & Rao, R. (2008). Neurodevelopmental outcome of infants with meconium aspiration syndrome: report of a study and literature review. Journal of perinatology : official journal of the California Perinatal Association, 28 Suppl 3, S93–S101. https://doi.org/10.1038/jp.2008.154

Blackwell, S. C., Moldenhauer, J., Hassan, S. S., Redman, M. E., Refuerzo, J. S., Berry, S. M., & Sorokin, Y. (2001). Meconium aspiration syndrome in term neonates with normal acid-base status at delivery: is it different?. American journal of obstetrics and gynecology184(7), 1422–1426. https://doi.org/10.1067/mob.2001.115120

Buinauskiene J, Baliutaviciene DK HYPOXIA AND MECONIUM ASPIRATION SYNDROME IN NEWBORN FROM LABOUR INDUCED WITH MISOPROSTOL Archives of Disease in Childhood 2008;93:ps231.

Choi, W., Jeong, H., Choi, S. J., Oh, S. Y., Kim, J. S., Roh, C. R., & Kim, J. H. (2015). Risk factors differentiating mild/moderate from severe meconium aspiration syndrome in meconium-stained neonates. Obstetrics & gynecology science58(1), 24–31. https://doi.org/10.5468/ogs.2015.58.1.24

Ciftci, A. O., Tanyel, F. C., Bingöl-Koloğlu, M., Sahin, S., & Büyükpamukçu, N. (1999). Fetal distress does not affect in utero defecation but does impair the clearance of amniotic fluid. Journal of pediatric surgery34(2), 246–250. https://doi.org/10.1016/s0022-3468(99)90183-5

Cleary, G. M., & Wiswell, T. E. (1998). Meconium-stained amniotic fluid and the meconium aspiration syndrome. An update. Pediatric clinics of North America45(3), 511–529. https://doi.org/10.1016/s0031-3955(05)70025-0

Dargaville, P. A., Copnell, B., & Australian and New Zealand Neonatal Network (2006). The epidemiology of meconium aspiration syndrome: incidence, risk factors, therapies, and outcome. Pediatrics, 117(5), 1712–1721. https://doi.org/10.1542/peds.2005-2215

FDA. (2018.). Cytotec misoprostol tablets. Accesdata FDA. Geraadpleegd op 19 december 2021, van https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/019268s051lbl.pdf

Fischer, C., Rybakowski, C., Ferdynus, C., Sagot, P., & Gouyon, J. B. (2012). A Population-Based Study of Meconium Aspiration Syndrome in Neonates Born between 37 and 43 Weeks of Gestation. International journal of pediatrics2012, 321545. https://doi.org/10.1155/2012/321545

Garcia-Prats, J. A. (2021, 29 juli). Meconium aspiration syndrome: Prevention and management. Up To Date. Geraadpleegd op 21 december 2021, van https://www.uptodate.com/contents/meconium-aspiration-syndrome-pathophysiology-clinical-manifestations-and-diagnosis?sectionName=PATHOPHYSIOLOGY&search=meconium&topicRef=5011&anchor=H3&source=see_link#H3 Ghidini, A., & Spong, C. Y. (2001). Severe meconium aspiration syndrome is not caused by aspiration of meconium. American journal of obstetrics and gynecology185(4), 931–938. https://doi.org/10.1067/mob.2001.116828

Gluck, O., Kovo, M., Tairy, D., Herman, H. G., Bar, J., & Weiner, E. (2020). The effect of meconium thickness level on neonatal outcome. Early human development142, 104953. https://doi.org/10.1016/j.earlhumdev.2020.104953

Hermus, M., Verhoeven, C., Mol, B. W., de Wolf, G. S., & Fiedeldeij, C. A. (2009). Comparison of induction of labour and expectant management in postterm pregnancy: a matched cohort study. Journal of midwifery & women’s health54(5), 351–356. https://doi.org/10.1016/j.jmwh.2008.12.011

van Heijst, M. L., van Roosmalen, G., & Keirse, M. J. (1995). Classifying meconium-stained liquor: is it feasible?. Birth (Berkeley, Calif.)22(4), 191–195. https://doi.org/10.1111/j.1523-536x.1995.tb00257.x

Hiersch, L., Krispin, E., Linder, N., Aviram, A., Gabbay-Benziv, R., Yogev, Y., & Ashwal, E. (2017). Meconium-Stained Amniotic Fluid and Neonatal Morbidity in Low-Risk Pregnancies at Term: The Effect of Gestational Age. American journal of perinatology34(2), 183–190. https://doi.org/10.1055/s-0036-1585056

Hutton, E. K., & Thorpe, J. (2014). Consequences of meconium stained amniotic fluid: what does the evidence tell us?. Early human development, 90(7), 333–339. https://doi.org/10.1016/j.earlhumdev.2014.04.005

Kitsommart, R., Thammawong, N., Sommai, K., Yangnoy, J., Bowornkitiwong, W., & Paes, B. (2021). Impact of meconium consistency on infant resuscitation and respiratory outcomes: a retrospective-cohort study and systematic reviewThe journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians34(24), 4141–4147. https://doi.org/10.1080/14767058.2019.1706476

KNOV. Factsheet meconiumhoudend vruchtwater. April 2015. https://werkgroepen.kennisnetgeboortezorg.nl/?file=10882&m=1500990435&action=file.download KNOV (2018). Vakkennis KNOV. Geraadpleegd op 4 januari 2022, van https://www.knov.nl/kennis-en-scholing/vakkennis-en-wetenschap/vakkennis?componentid=5439491&title=Meconiumhoudend%252bvruchtwater

Liu, W. F., & Harrington, T. (2002). Delivery room risk factors for meconium aspiration syndrome. American journal of perinatology19(7), 367–378. https://doi.org/10.1055/s-2002-35611

Maisonneuve, E., Audibert, F., Guilbaud, L., Lathelize, J., Jousse, M., Pierre, F., Fraser, W., & Carbonne, B. (2011). Risk factors for severe neonatal acidosis. Obstetrics and gynecology118(4), 818–823. https://doi.org/10.1097/AOG.0b013e31822c9198

Meydanli, M. M., Dilbaz, B., Calişkan, E., Dilbaz, S., & Haberal, A. (2001). Risk factors for meconium aspiration syndrome in infants born through thick meconium. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics72(1), 9–15. https://doi.org/10.1016/s0020-7292(00)00265-4

Monfredini, C., Cavallin, F., Villani, P. E., Paterlini, G., Allais, B., & Trevisanuto, D. (2021). Meconium Aspiration Syndrome: A Narrative Review. Children (Basel, Switzerland), 8(3), 230. https://doi.org/10.3390/children8030230

NICE. Intrapartum care. Care of healthy women and their babies during childbirth. Londen: NICE; 2014. NVOG. Meconiumhoudend vruchtwater. Utrecht: NVOG; 2011.

https://www.nvog.nl/wp-content/uploads/2017/12/Meconiumhoudend-vruchtwater-1.0-23-03-2011.pdf

NVOG. Zwangerschapscholestase. Utrecht: NVOG; 2011.

https://www.nvog.nl/wp-content/uploads/2018/08/Zwangerschapscholestase-NVOG-23-3-2011.pdf

Panicker, R., Win, L. L., & Moopil, J. (2019). Meconium-stained Amniotic Fluid Revisited: A Holistic Perspective. Journal of South Asian Federation of Obstetrics and Gynaecology, 11(2), 131–133. https://doi.org/10.5005/jp-journals-10006-1658

Parer, J. T., King, T. L., & Ikeda, T. (2017). Electronic Fetal Heart Rate Monitoring: The 5-Tier System: The 5-Tier System (3de editie). Jones & Bartlett Learning. Paz, Y., Solt, I., & Zimmer, E. Z. (2001). Variables associated with meconium aspiration syndrome in labors with thick meconium. European journal of obstetrics, gynecology, and reproductive biology94(1), 27–30. https://doi.org/10.1016/s0301-2115(00)00335-3

Rahman, S., Unsworth, J. & Vause, S. (2010). Review: Meconium in Labour. Obstetrics, Gynaecology & Reproductive Medicine, 20(10), 289-294. https://doi.org/10.1016/j.ogrm.2010.06.005

Reed, R. (2015, 14 januari). The Curse of Meconium Stained Liquor. MidwifeThinking. Geraadpleegd op 19 december 2021, van https://midwifethinking.com/2015/01/14/the-curse-of-meconium-stained-liquor/

Scott, H., Walker, M., & Gruslin, A. (2001). Significance of meconium-stained amniotic fluid in the preterm population. Journal of perinatology : official journal of the California Perinatal Association21(3), 174–177. https://doi.org/10.1038/sj.jp.7200521

Singh, B. S., Clark, R. H., Powers, R. J., & Spitzer, A. R. (2009). Meconium aspiration syndrome remains a significant problem in the NICU: outcomes and treatment patterns in term neonates admitted for intensive care during a ten-year period. Journal of Perinatology, 29(7), 497–503. https://doi.org/10.1038/jp.2008.241

Sherman, D. J., Ross, M. G., Day, L., Humme, J., & Ervin, M. G. (1991). Fetal swallowing: response to graded maternal hypoxemia. Journal of applied physiology (Bethesda, Md. : 1985)71(5), 1856–1861. https://doi.org/10.1152/jappl.1991.71.5.1856

Vivian-Taylor, J., Sheng, J., Hadfield, R. M., Morris, J. M., Bowen, J. R., & Roberts, C. L. (2011). Trends in obstetric practices and meconium aspiration syndrome: a population-based study. BJOG : an international journal of obstetrics and gynaecology, 118(13), 1601–1607. https://doi.org/10.1111/j.1471-0528.2011.03093.x

Wiswell, T. E., & Bent, R. C. (1993). Meconium staining and the meconium aspiration syndrome. Unresolved issues. Pediatric clinics of North America40(5), 955–981. https://doi.org/10.1016/s0031-3955(16)38618-7 Xu, H., Wei, S., & Fraser, W. D. (2008). Obstetric approaches to the prevention of meconium aspiration syndrome. Journal of perinatology : official journal of the California Perinatal Association28 Suppl 3, S14–S18. https://doi.org/10.1038/jp.2008.145

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