Re: [ozmidwifery] Interesting..

[Anne Clarke]

Dear Mary,   The FLF is reabsorbed into the lung capillaries prior to and during labour (autonomic and hormonal response) this is why it can be recommended to some women who are planning a caesarean be given a choice to 'labour for a while' to signal to the baby to start absorbing lung fluid.   This is why, unless an underlying cause e.g. fetal distress is present, babies that have a caesarean birth after the mother has laboured do better than those babies from a 'cold' caesarean, who are more likely to have the malabsorpiton problem.   Regards, Anne Clarke ----- Original Message ----- From: Mary Murphy To: [EMAIL PROTECTED] Sent: Saturday, May 31, 2003 11:50 AM Subject: Re: [ozmidwifery] Interesting.. Re the squeeze.. If it is not the natural birth process which squeezes the FLF, then why is it that many C/S, especially those who do not labour, have fluid in their lungs and require extra care in Special Nursery?  MM ----- Original Message ----- From: Gayle Rafferty To: [EMAIL PROTECTED] Sent: Friday, May 30, 2003 10:06 PM Subject: Re: [ozmidwifery] Interesting.. Thanks for your reply Marilyn.  Your apneic baby could be the result of a placental insufficiency, cord compression, anaemia of the mother and generally any condition that will lead to a lack of oxygen to supply the baby through the placenta, including true or false knots in the cord. Respiration, oxygenation, nutrition, elimination occurs through the exchange of gases and waste products through the placenta.  The closer to delivery, the more senile and non-functional the placenta becomes. Another possibility is an anemic baby, whose Hering Bruer reflex is initiated in response to hypoxia.  Worthy of note is that fetal breathing movements are just that, movements - they are not breathing, per se.  I verified this today with an ultrasonographer who regularly performs biophysical profiles.  He stated that they do not, can not, inhale against a closed glottis. Try it for yourselves.  The fetal lung fluid and amniotic fluid remain separate, as Anne Clark also pointed out.  Must admit Anne, I was not aware that the squeeze doesn't clear the FLF.  Thanks. Mary, I would really like to know a little more of the ante natal and intrapartum details of the MSL/MSA C/S baby.  Also whether any organism was cultured from the baby's aspirate (if taken).  Was there any ROM prior to delivery?  Was mother anaemic, healthy, laboring prior to C/S? Febrile, negative GBS /other culture?  Gayle       -------Original Message-------   From: [EMAIL PROTECTED] Date: Friday, 30 May 2003 10:31:34 PM To: [EMAIL PROTECTED] Subject: Re: [ozmidwifery] Interesting..   I thought so too Lesley, but this info was making me rethink that. But I think that is what happens. Without the gasp the mec liquor wont enter the lungs with normal fetal breathing and I guess from the other comments, if you have periodic late decels during labour and mec liquor then you have a potentially apneic baby, and a potential gasp,  but you wont know unless you're looking. Interesting.   marilyn ----- Original Message ----- From: Lesley Kuliukas To: [EMAIL PROTECTED] Sent: Thursday, May 29, 2003 5:50 PM Subject: Re: [ozmidwifery] Interesting.. I always believed it was secondary or terminal apnoea that caused the baby to gasp whether inside or outside of the uterus. Lesley ----- Original Message ----- From: Mary Murphy To: [EMAIL PROTECTED] Sent: Thursday, May 22, 2003 4:25 PM Subject: Re: [ozmidwifery] Interesting.. Marilyn wrote "Yet most babies with mec liquor don't present with MAS. And some (a very few) babies with very normal uncomplicated labours and births do develop MAS. Is it the gasp of a baby in distress (which may happen at any time and be undetected) or just a random gasp that carries the mec deep into the lungs ? Just curious"   I'm curious too.  I haven't read any studies about that.  Maybe it hasn't been done yet, or can't ethically be done?  Does anyone know?  MM