morphine and Kidney-Diseases

Topics: Air; Amniotic Fluid; Animals; Asphyxia Neonatorum; Cardiomyopathies; Contraindications; Disease Susceptibility; Dose-Response Relationship, Drug; Europe; Humans; Hypoxia; Infant, Newborn; Kidney Diseases; Meconium; Models, Animal; Muscle Hypotonia; Neoplasms; Oxygen; Oxygen Inhalation Therapy; Practice Guidelines as Topic; Resuscitation; United States

The cause of fetal distress and neonatal respiratory distress (RD) in association with meconium-stained liquor is not always clear. To clarify this, a prospective study was undertaken in a tertiary referral maternity hospital for 1 year. In all infants born after meconium-stained liquor who developed RD, evidence was sought for 1) fetal distress (from the cardiotocograph (CTG), the cord blood pH, the Apgar score and the asphyxial complications in the neonate) 2) causes of fetal distress (including maternal risk factors, fetal infection and fetal malnutrition) 3) causes of respiratory distress (including meconium aspiration syndrome (MAS), persistent pulmonary hypertension of the newborn (PPHN) and infection). Of 4,026 livebirths, 717 (17.8%) had meconium-stained liquor and 44 term and 5 preterm infants developed RD. In the 44 term infants, there was frequent evidence of fetal distress possibly caused by previously unrecognized factors such as fetal malnutrition with reduced neonatal skinfold thickness in 35% triceps and 41% subscapular measurements, and histological chorioamnionitis (CA) in 74%. The cause for respiratory distress was identified in only 48% of infants, and included clinical evidence of PPHN (41%), MAS (16%) and infection (2%). However in preterm infants, 80% had definite or suspected infection. The findings indicate that fetal distress is common in infants who develop respiratory distress after meconium-stained liquor. A role for histological CA and reduced nutrition in the fetus, as factors contributing to the vulnerability of the term infant to intrapartum fetal distress, is suggested.

Topics: Apgar Score; Chorioamnionitis; Female; Fetal Blood; Fetal Diseases; Fetal Distress; Heart Rate, Fetal; Hospitals, Maternity; Humans; Infant, Newborn; Infant, Premature; Kidney Diseases; Meconium; Meconium Aspiration Syndrome; New South Wales; Nutritional Status; Persistent Fetal Circulation Syndrome; Pregnancy; Prospective Studies; Radiography; Respiratory Distress Syndrome, Newborn; Risk Factors; Sepsis; Skinfold Thickness

Topics: Asphyxia; Asphyxia Neonatorum; Blood Glucose; Blood Viscosity; Brain Diseases; Female; Fetal Diseases; Fetal Growth Retardation; Humans; Hypocalcemia; Hypoglycemia; Infant, Newborn; Infant, Newborn, Diseases; Inhalation; Kidney Diseases; Meconium; Polycythemia; Pregnancy; Prognosis; Syndrome

Topics: Abdomen, Acute; Cysts; Diagnosis, Differential; Digestive System Abnormalities; Female; Follow-Up Studies; Hemangioma; Humans; Hydronephrosis; Infant, Newborn; Infant, Newborn, Diseases; Kidney Diseases; Kidney Neoplasms; Liver Neoplasms; Male; Meconium; Neuroblastoma; Ovarian Cysts; Peritonitis; Polycystic Kidney Diseases; Renal Veins; Retroperitoneal Neoplasms; Stomach Neoplasms; Teratoma; Thrombophlebitis; Uterine Diseases; Vaginal Diseases