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I was reading this website saying that fetuses urinate into the amniotic fluid. It also mentioned that, because we drink the amniotic fluid, we've been drinking our urine for months.
However, why do we produce urine as fetuses? I always believed the placenta was our source of waste removal; then why have fetuses the need for filtering their blood through their own kidneys?
In addition, why would fetuses drink the amniotic fluid? Is there a benefit for doing that?
In utero, the growing little human is getting ready to be an independently functioning individual. While it is everything but that, it must be able to obtain fluids and nutrients through its mother's milk, and that from pretty much the first hour of its life.
To develop proper kidney function, the growing fetus needs to ingest fluids just as it will do post partum. Because a mini bar isn't available, it has to drink whatever is available, i.e., amniotic fluid and indeed, its own urine. Shortly after the kidneys start to produce urine, the fetal swallowing commences.
Amniotic fluid is 98% water and 2% salts and cells from the baby. Until the fetal kidneys start working during month four, amniotic fluid is made by the mother's body. But after month 4, the fetus starts to make his contribution to the amniotic fluid by urinating into it (Penn Medicine). Production of amniotic fluid is then 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). Fetal breathing movements also contribute by efflux of lung fluid into the amniotic fluid. Removal of AF is predominately accomplished by fetal swallowing (200 to 250 ml/kg fetal weight/day) (Underwood et al., 2005).
The water in amniotic fluid originally comes from maternal plasma and passes through the fetal membranes. As the placenta develops, water and solutes from maternal plasma pass across the placenta to the fetus and then to the amniotic fluid (Underwood et al., 2005), see Fig. 1.
Swallowing its own urine is not only not dangerous, it is essential to proper development. A decrease in fetal urine production or excretion can result in a reduced amount of amniotic fluid (oligohydramnios). Oligohydramnios can result in fetal lung deformations (pulmonary hypoplasia) and increased risk of infection. Fetal mortality rates as high as 80-90% have been reported with oligohydramnios diagnosed in the second trimester (Source: Patient Info).
If the fetus would have to prevent the production of urine in utero, the kidneys would have to remain nonfunctional during development, which would be disastrous once it is born. Renal failure is in fact pretty common in newborns, but can be fatal without proper treatment (Andreoli, 2004).
Fig. 1. After month 4, amniotic fluid is derived from maternal plasma that passes via the placenta, to the fetus and then to the amnionic fluid. Source: Underwood et al., (2005).
- Andreoli, Semin Perinatol (2004); 28(2): 112-23)
- Underwood et al., J Perinatol (2005); 25: 341-48
Why amniotic fluid levels during pregnancy matter
There are many reasons you may have too much or too little amniotic fluid during pregnancy. Here’s what you need to know.
At her 30-week prenatal checkup, Ali Feeney’s belly was measuring small, so her obstetrician sent her for an ultrasound. She went to the hospital for the scan on her lunch break the day she was training her maternity leave replacement, but didn’t return to the office. When the ultrasound showed Feeney’s amniotic fluid was dangerously low, she was quickly given a non-stress test to check on the baby’s movement and heart rate. If the results were abnormal, she was warned she may need an emergency C-section.
“It was stressful and I had a million questions,” says the Ottawa mom, who was living in Vancouver at the time. “I was wondering, Is it something I did? Is it because I have a cup of coffee a day?”
Upon checking, the baby’s heart rate was fine and she was moving normally. But Feeney was immediately put on modified bed rest and urged to drink lots of water to help build up her fluid. From that moment on, Feeney says she set a goal for herself of drinking 20 glasses of water a day, and she gave up her morning coffee. (Drinking a normal amount of water per day—eight glasses—is fine during pregnancy. It was Feeney’s personal choice to cut coffee altogether. Limiting caffeine to 200 to 300 mg a day is the recommendation during pregnancy.)
HELLP Syndrome: A rare, scary pregnancy illness you should know about Instead of spending her third trimester wrapping up things at the office, browsing for baby gear in boutiques and going for long walks on the beach with her husband, Feeney worked remotely, shopped online and went to the hospital two or three times a week for monitoring.
“Amniotic fluid provides protection, cushioning and a nice, warm environment for the baby to thrive and grow,” says Kenneth Lim, head of maternal fetal medicine at BC Women’s Hospital in Vancouver. “It’s also a rough indicator of the baby’s health status.”
Amniotic fluid levels are assessed during routine ultrasounds. If your last ultrasound was at the 20-week mark, and you don’t have another one scheduled, you would only find out about a fluid level issue later in pregnancy if you or your provider notices other concerns and an additional ultrasound is performed. (For example, if your bump isn’t measuring consistently with gestational age if there’s been a decrease in fetal movement if you have high blood pressure or if your doctor or midwife suspects the baby might be breech.)
There are different techniques for measuring amniotic fluid, but the Society of Obstetricians and Gynaecologists of Canada (SOGC) recommends measuring—on an ultrasound image—the single deepest pocket of fluid. A pocket deeper than eight centimetres and wider than one centimetre means you have too much fluid, known as polyhydramnios. A pocket less than two centimetres deep and one centimetre wide is considered too little, or oligohydramnios. Less than 10 percent of women will have oligohydramnios or polyhydramnios diagnosed on an ultrasound. Both conditions can cause complications or be a sign of an underlying condition in the baby or mother.
Amniotic fluid comes from different sources: the fetus, the placenta, and the mother. In the second trimester, urine becomes the main ingredient when the baby begins to swallow the fluid and her kidneys start working. Amniotic fluid helps the baby’s bones, muscles, lungs and digestive system develop, and ensures the umbilical cord doesn’t get compressed. At 20 weeks pregnant, women have about 400 millilitres of fluid. The volume doubles to 800 millilitres at 28 weeks gestation, and remains at that level until 37 weeks, when it starts to go down. When babies are born, they have 400 to 500 millilitres in their amniotic sac—that’s about two cups of fluid.
“The fluid around your baby in the uterus is a balance between production and removal,” Lim says. “Any time we diagnose high fluid or low fluid, it adds another question, which is, Why?”
The most common explanation for low fluid is a leak in the amniotic sac. The mother may also be dehydrated or there may be a problem with the placenta. Sometimes the baby has kidney problems or a urinary track blockage, or excess fluid can build up when the baby has trouble swallowing due to a birth defect. Diabetes in the baby or mother can also lead to polyhydramnios.
Often, there is no known cause, as was the case with Feeney. By 36 weeks, she had increased her fluid to a normal level, but her baby was breech, likely because she didn’t have enough water to help her get into position. Feeney had a scheduled C-section at 38 weeks and baby Sloane was born healthy and without complications.
“There are going to be many cases where there’s high fluid or low fluid and the kid is perfectly fine,” says Lim. “We always have to remember that it doesn’t necessarily mean that there’s something wrong. But the worse it gets, the more likely there is truly something wrong that needs to be managed by a health care professional.”
Usually, women with high or low fluid will be closely monitored. In serious cases, amniotic fluid may need to be removed with a needle or—rarely, in very special circumstances—fluid (usually a saline solution) can be added through a catheter, says Lim. Sometimes, a woman’s body may be tricked by the excess fluid into thinking it’s time to deliver, causing premature labour.
That was Stephanie Somers’s biggest fear. After learning that she had gestational diabetes with her second child, a diagnosis of polyhydramnios soon followed, at 29 weeks. She was warned some of her fluid may have to be removed. By 37 weeks, the Sidney, BC, mom was measuring 42 weeks and her baby was also breech —because she had so much extra water to bob around in. “That’s when it got really scary,” Somers says. “I was told that if my water breaks, I had to get to the hospital immediately.”
Doctors were worried about cord prolapse, when the umbilical cord comes out before the baby, due to the baby’s position and the volume of fluid. As soon as Somers felt a tickle of a contraction, she headed into the hospital and had a C-section. “Wow! That’s a lot of water,” someone in the delivery room said as baby Delilah was born.
While women with oligohydramnios and polyhydramnios are at greater risk of preterm labour, C-sections and stillbirth, the majority of mothers have healthy babies. “In most cases, everything is going to turn out fine,” Lim says. “It’s rare to have bad outcomes in relation to abnormalities of amniotic fluid.”
The Importance of Amniotic Fluid
Amniotic fluid is produced as soon as the gestational sac is formed and, along with the developing embryo (and later fetus), is contained within the amniotic sac. The amniotic sac is a thin but tough pair of membranes that is contained within the gestational sac and is also known as the &ldquobag of waters.&rdquo
Amniotic fluid is initially generated solely by the mother&rsquos plasma but when the fetal kidneys begin to function at around week 16, fetal urine also contributes to the fluid. Although initially absorbed through the fetal tissue, once the fetus&rsquo skin is keratinized the amniotic fluid is absorbed by the fetal gut when the fetus ingests the liquid.
In the beginning amniotic fluid mainly comprises water with electrolytes but by around week 12 to 14 it also contains lipids, carbohydrates, urea, protein, and phospholipids &ndash all of which are vital in helping the fetus to develop.
The volume of amniotic fluid increases as the fetus grows &ndash increasing from 25 ml to 400 ml between the 10 th and 20 th weeks of pregnancy. The volume reaches a plateau of 800 ml by 28 weeks of pregnancy but then declines to around 400 ml by 42 weeks of pregnancy.
If the amniotic sac ruptures prematurely or if the amniotic sac ruptures at term but labor is not imminent, there is an increased risk of infection as bacteria are now able to enter the amniotic sac. In addition, it can also increase the risk of cord compression. If either of these situations occurs you should get yourself to the hospital as soon as possible in order to undergo appropriate treatment.
What is the function of amniotic fluid?
Amniotic fluid protects the developing fetus by providing a barrier between the fetus and the mother&rsquos abdomen protecting it from blows and mechanical shocks. It also allows for easier fetal movement and promotes development of the muscles and skeleton of the fetus. Amniotic fluid also creates urine when swallowed and contributes to the formation of meconium, the earliest stool of your baby.
It was thought that the fetus inhaled and exhaled amniotic fluid, but actually there is no inward flow of amniotic fluid into the airway. Instead, lung development occurs due to the production of fetal lung fluid which expands the lungs.
It is important that the fundal height be measured and properly recorded to track proper fetal growth and the increasing development of amniotic fluid. You should also be undergoing regular ultrasounds by your healthcare provider which will give an additional indication of proper fetal growth and amniotic fluid development.
Why amniotic fluid levels during pregnancy matter
Although a low level of amniotic fluid (also called oligohydramnios) often results in a healthy pregnancy and baby, it can cause or indicate issues for both the baby and the mother. Babies surrounded by too little amniotic fluid can develop clubbed feet or hands, contractures of the limbs, or can develop a potentially fatal condition called hypoplastic lungs whereby the lungs are small and underdeveloped. This means that when the baby is born he or she can die due to lack of oxygen.
Oligohydramnios can be caused by infection, kidney dysfunction or malformation (since much of the late amniotic fluid volume is urine), and procedures such as chorionic villus sampling and premature rupture of membranes. It can sometimes be treated with bed rest, antibacterials, steroids, oral and intravenous hydration, and amnioinfusion.
At the other end of the spectrum there can be an excessive amount of amniotic fluid in the amniotic sac during pregnancy &ndash this is called polyhydramnios. In this situation the fetus can be at risk for a number of problems such as cord prolapse, placental abruption, premature birth, and perinatal death.
There is also an often fatal condition associated with the amniotic fluid called amniotic fluid embolism. In this condition amniotic fluid enters the bloodstream of the mother, triggering a serious reaction which then results in collapse of the lungs and heart and excessive bleeding. Luckily, this condition is extremely rare!
How are amniotic fluid levels measured?
During each prenatal visit, your healthcare provider should measure your fundal height with a tape measure. The fundal height is measured from the top of your uterus to the top of your pubic bone and gives a good estimation of the size of your uterus. It is important that the fundal height be measured and properly recorded to track proper fetal growth and the increasing development of amniotic fluid. You should also be undergoing regular ultrasounds by your healthcare provider which will give an additional indication of proper fetal growth and amniotic fluid development.
The child swallowed amniotic fluid
There are many myths about what to expect when a newborn swallows amniotic fluid, as well as what consequences it will lead to. If this happened to your baby, then listen only to doctors and do not ask for advice from friends or on online forums. Each case is individual: one woman can even forget about such an unpleasant event, because her baby did not have any complications, the other mother survived many sleepless nights in anticipation of the day when the life threat for her crumbs is over.
Is it dangerous?
If the baby swallowed amniotic fluid at birth, the consequences and possible risk depend on the color of the amniotic fluid.
If clean and clear water gets into the baby’s airways, this can cause inflammation in the bronchi or lungs, but this rarely happens and depends on the individual characteristics and protective functions of the baby’s body.
Ingestion of liquid through the mouth and its penetration into the stomach does not pose a danger to the crumbs, because the entire period of intrauterine development, he was in this environment. European obstetricians are of the opinion that amniotic fluid, when it enters the gastrointestinal tract, does not cause poisoning, since it is not toxic.
But the clinical picture is quite different when the child swallowed green amniotic fluid.
Ingestion of meconium can cause digestive disorders in the baby, which are manifested as follows:
Aspiration of contaminated water and its entry into the airways has even more negative consequences:
- the development of oxygen starvation
- infectious and inflammatory pathology of the respiratory system
- threat to the life of the child.
When the amniotic fluid has a high level of contamination, an emergency caesarean section is recommended to avoid negative consequences on the child’s body.
Where do green waters come from?
The appearance of amniotic fluid is directly related to the state of maternal and child organisms. Therefore, a change in the color of the water or its clouding is an alarming signal for medical personnel and is a sign, and if a child swallows green amniotic fluid, urgent action is required.
Darkening of the waters is often found in obstetric practice. You should not immediately start to panic if the doctor told you about it, because the reasons for changing the color of amniotic fluid can be different and do not always pose a serious threat to the condition of the baby. In addition, this phenomenon has not yet been fully studied by the medical scientific community.
The reasons for staining of the amniotic fluid in green are as follows:
- Isolation of meconium. In a third of cases when there is a darkening of the waters, this is due to the fact that the baby, while still in the mother’s womb, empties its intestines, although this usually happens 1-2 days after birth. It is the original feces that gives the green color to the waters.
- Hypoxia. Due to the aging of the placenta during pregnancy, the baby may not have enough oxygen to breathe.
- Infection. If a woman during the expectation of a baby suffered a cold or other infectious disease, this can cause infection of the amniotic fluid.
- Genetic violation. Congenital abnormalities of the fetus often contribute to the staining of water.
- Nutrition. There is a hypothesis that the green food eaten the day before can change the color of the amniotic fluid, however, this statement has no official confirmation.
If the child swallowed amniotic waters during childbirth, this indicates the need for a full examination of the baby and, if necessary, assistance.
Aspiration of amniotic fluid contaminated with original feces occurs in no more than 1-2% of newborns. In general, this is a frequent occurrence in obstetric practice, the mechanisms of occurrence of which are not yet fully understood.
Most susceptible to aspiration syndrome:
- born children
- born on time, but with pronounced signs of oxygen deficiency
- babies who have congenital developmental pathologies.
Various conditions can lead to a premature exit of meconium in the fetus, but most often this occurs with asphyxiation and severe stress, which causes increased intestinal motility and emptying.
What if the newborn swallowed amniotic fluid?
How atraumatic and safe the process of the birth of a baby will go is largely dependent on the qualifications of the doctor and the paramedical staff helping to give birth. An experienced doctor will help prevent a child from swallowing amniotic fluid during childbirth, and if this happens, he will take timely measures to remove fluid from the oropharynx, preventing it from entering the stomach or lungs.
When the ingestion of infected amniotic fluid nevertheless occurred, the infant is placed in the intensive care unit, where its condition is monitored around the clock.
If after a couple of days the baby does not show signs of an eating disorder or inflammatory processes of the bronchial tree or lungs, then he will be transferred to the ward to his mother, and after a while both will be discharged home. For preventive purposes, a newborn is given a course of antibiotic therapy to prevent possible infection.
If the child during childbirth swallowed amniotic fluid, then the doctor performs the following actions:
- If meconium clots are present in the water, the nasal cavity and mouth are cleaned of it at the moment when the head was born, and the chest has not yet left the mother’s womb.
- After birth, tracheal intubation is performed and amniotic water that has penetrated the respiratory organs is sucked out.
- The stomach of the newborn is cleaned, which prevents repeated aspiration in case of regurgitation.
- Carrying out oxygen therapy, in difficult situations, mechanical ventilation is indicated.
- The baby is prescribed preventive antibiotics to prevent the development of infection.
It is important for the mother to establish breastfeeding, as breast milk is not only food for the newborn, but also a way to calm down, feel safe, having heard the sound of her own heart. Through breast milk, the baby receives immunoglobulins from her mother, which ensure the immature organism’s resistance to the action of infectious agents.
Rarely, but there are times when doctors may not notice that the baby swallowed the amniotic fluid. Even if the newborn began to breathe independently and made the first cry, this does not mean that you can relax and forget about the aspiration of amniotic fluid.
If a baby swallows amniotic fluid at birth, the consequences may occur after some time. In the first month of life, young parents need to pay attention to any changes in his behavior and well-being.
If the following symptoms are found in the baby, consult a pediatrician in order not to miss the onset of the disease:
- dry cough
- during inhalation and exhalation unnatural sounds are heard
- spitting up.
The timely provision of medical care will help to avoid the development of serious complications.
In a situation when the child swallowed amniotic fluid during childbirth, there is a high probability of consequences. Especially if the amniotic fluid was not sterile due to meconium or infection.
If water is contaminated with meconium, it may develop :
- bronchitis in the first month of an infant’s life
- inflammatory processes of an infectious nature in the lung tissue
- digestive disorders
- weakened immunity in a baby due to the ingress of pathogenic microflora into the sterile intestines of the child.
If the neonatologist immediately after birth correctly diagnosed where the amniotic fluid penetrated and took measures to aspirate the contents from the gastrointestinal tract or respiratory tract, then the consequences will most likely be avoided.
So that the baby does not have to swallow the amniotic waters contaminated with the original feces, the mother needs to carefully monitor herself throughout the pregnancy:
- avoid contact with sick people
- to prevent ARVI and influenza
- Do not visit crowded places in order not to become infected with an infectious disease.
When water flows outside the hospital walls, attention should be paid to their shade. If the liquid has a green color, then you should urgently contact the emergency room of the maternity hospital so that the medical staff can provide timely assistance to both the baby and mother.
If amniotic waters have a high degree of infection, an emergency caesarean section is performed. After childbirth, it is important how quickly and correctly the doctor cleans the oropharynx of the baby from amniotic fluid.
When water is swallowed directly in the birth process, in most situations this does not adversely affect the baby’s well-being.
Every expectant mother must remember that her actions can adversely affect not only herself, but also the development of the child. An important role is played by how the birth of crumbs to the light occurs.
If during childbirth a child swallowed amniotic fluid, do not panic. Such an incident does not always have consequences for the baby, but even with aspiration of contaminated fluid, the crumbs have every chance to fully grow and develop, because doctors will make every effort to restore the newborn.
What is the function of the amnion and the amniotic fluid?
Rest of the in-depth answer is here. Similarly, what is the function of the amniotic fluid?
Amniotic fluid protects the developing baby by cushioning against blows to the mother's abdomen, allowing for easier fetal movement and promoting muscular/skeletal development. Amniotic fluid swallowed by the fetus helps in the formation of the gastrointestinal tract.
Subsequently, question is, what is amniotic fluid made of? At first, amniotic fluid consists of water from the mother's body, but gradually, the larger proportion is made up of the baby's urine. It also contains important nutrients, hormones, and antibodies and it helps protect the baby from bumps and injury.
Also question is, what is the function of amnion and Chorion?
The amnion is the inner membrane that surrounds the embryo, while the chorion surrounds the embryo, the amnion, and other membranes. 3. The amnion is filled with amniotic fluid that holds the embryo in suspension, while the chorion also acts as a protective barrier during the embryo's development.
What is amnion in biology?
Definition. noun, plural: amnions. The innermost membrane of the extraembryonic or the fetal membranes of amniotes surrounding the embryo or the fetus. Supplement. Amniotes are characterized by their amnion, which is part of membranes surrounding the developing embryo or fetus.
Amniotic fluid is important in the development of fetal organs, especially the lungs. Too little fluid for long periods may cause abnormal or incomplete development of the lungs called pulmonary hypoplasia. Intrauterine growth restriction (poor fetal growth) is also associated with decreased amounts of amniotic fluid. Oligohydramnios may be a complication at delivery, increasing the risk for compression of the umbilical cord and aspiration of thick meconium (baby's first bowel movement).
The following are the most common symptoms of oligohydramnios. However, each woman may experience symptoms differently. Symptoms may include:
Leaking of amniotic fluid when the cause is rupture of the amniotic sac
Decreased amount of amniotic fluid on ultrasound
The symptoms of the oligohydramnios may resemble other medical conditions. Always consult your doctor for a diagnosis.
Most women diagnosed with low amniotic fluid in the third trimester will have a completely normal pregnancy. If there are very low levels of amniotic fluid for your baby to float around in, there is a slight risk of intrauterine growth restriction and umbilical cord constriction during birth. You may also be more likely to have a C-section.
If your doctor detects low amniotic fluid in the first or second trimesters, the risks are greater and may include miscarriage, premature birth, birth defects or stillbirth.
Amniotic Fluid: What It Is and Why It's Important
The truth? Amniotic fluid is pee. Well, mostly pee. When the fluid first starts to form inside the amniotic sac (a few weeks after conception), it’s mostly made of your own body fluids. But when baby’s kidneys kick in and start putting out urine (at as early as 11 weeks), those new fluids start building up to help cushion and protect baby’s growing body. After around week 20, the amniotic fluid is mostly urine.
This all might sound a little gross at first, but thank goodness for those fluids! They keep baby safe in case you fall, push out on the uterine walls to give baby more space (and allow for more practice wiggling around), help baby learn how to breathe and swallow, and serve as protection from infection by stopping the growth of certain types of bacteria.
The amniotic fluid also contains skin cells that have shed from baby, which means your doctor can use it to test for some genetic disorders.
Expert source: American College of Obstetrics and Gynecologists. Your pregnancy and birth. 4th ed. Washington, DC: ACOG 2005.
Treatments Available for Oligohydramnios
In case of low volumes of amniotic fluid, the woman has to take substantial amounts of fluid throughout the day. Besides, the doctors recommend early delivery to prevent miscarriage. As the volume of fluid keeps on decreasing, the living conditions become unfavourable for the baby. In case a tear develops in the sac, the fluid starts coming out slowly. It may not force its way out with a gush, but certainly, it leaks out of the sac. In these cases, it is wise to get the baby out of the womb at the earliest. This often results in premature birth, between 32 to 37 weeks of pregnancy. However, the chances of stillbirth can be greatly minimized in case the amount amniotic fluid decreases in the sac.
A commonly adopted measure to treat this condition is to inject saline into the amniotic sac. This replenishes the volume of fluid in the womb and creates a favourable environment for the child to survive. The saline water creates amniotic fluid. This is known as amnioinfusion. The umbilical cord comes under pressure when the fluid quantity drops. This process relieves the cord from pressure.
Although doctors can safely get the child out of the womb during these complications, it may result in cesarian delivery. In case you realize that you are not gaining weight at the expected rate, it might be a symptom of Oligohydramnios. It occurs in 4% of pregnant women, but the chances of miscarriage can be reduced if it is detected early.
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Do Babies Poo in the Womb?
Now that we’ve answered the question “Do babies pee in the womb?” it’s time to see whether they also defecate there. The first thing you should know is that fetal defecation in the womb is not standard. Since their intestines are barely developed, fetuses amass their wastes into a conglomerate of greenish feces that is known as meconium. Unlike the feces of older children or adults, meconium is completely sterile and odorless. Moreover, it’s stored as solid waste within the bowel.
Since fetuses don’t get proper meals in the womb, meconium forms in a very different way than our feces do. Meconium mostly contains mucus, bile, intestinal epithelial cells, and the fine body hairs known as lanugo. It also contains vernix caseosa, which is a normal sebaceous secretion that lubricates the epidermis.
Although unborn babies aren’t supposed to pass the meconium in their intestines until after delivery, pooping in the womb is not all that rare. It’s estimated that around 12 percent of fetuses just cannot help but poo before birth. Babies that fall into this percentage have meconium-stained amniotic fluid (MSAF) that has been colored yellowish or greenish from the pigments in the bile contained in the waste. This can be a source of concern. Why? Because the meconium could potentially enter the fetus’ airways. This would lead to a certain respiratory condition known as meconium aspiration syndrom. While MAS can be fatal if prolonged during post-term pregnancies, the rate of fetal death due to this condition is steadily declining in developed countries due to advanced medical treatments.