Aging of the Male Germline: Influence of Advanced Male Age on Reproductive Outcome

The rise in life expectancy and the desire to establish a stable career prior to parenthood leads couples to a delayed childbearing. Advanced parental age at the time of pregnancy portrays several risks, with the majority of couples above 35 experiencing reproductive impairments.

While the effect of women’s age on fertility is well known, the influence of paternal age is less understood. Thus, efforts have been made to comprehend the influence of APA on pregnancy upkeep and disease risk for the offspring.

Over the last decades numerous studies aimed to establish the relationship between APA and male fertility potential. It has been found that APA is related to testicular and hormonal alterations, along with a decreased sperm production, quality and DNA integrity.

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The National Quality Plan and More Caesarean Sections, Less Wound Infections,more Gestational Diabetes (GDM) and Fewer Smokers in Northern Norway: A Registry-based Retrospective Study

 The Ministry of Health and Care Service’s plan for improved maternity and delivery care was implemented in Northern Norway in March 2012. Selection criteria were standardized and economic resources allocated. Methods: We explored the effects in a retrospective quality of care study employing data from the Medical Birth Registry of Norway (MBRN). The prior study (2009-11) was compared with the 2012-14 period.

The levels of care were Midwife administered maternity units (MAMU), Departments of Obstetrics and Gynaecology (DOG) and Regional Clinics of Obstetrics and Gynaecology (RCOG). National data on post-caesarean surgical wound infection (2009-2014) was added.

Quality of care was defined as rate of multiple pregnancies, eclampsia, vacuum or forceps assisted delivery, births during transportation, caesarean section rate, post-caesarean wound infection, perineal rupture, smoking habits, body mass index (BMI), Apgar score <7, birth weight <2.5 kg and stillbirth.

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Call to Action: Motivating Moms to Move

The findings published by Flegal and colleagues report a linear increasing trend in overweight and obesity among US women (40%). The recent reported rise in obesity among American women is not only alarming for the many women that will suffer from the adverse health effects brought on by the disease but also for future generations of children that are born to mothers that are overweight or obese.

This worrying trend is not specific to the United States. According to the WHO, approximately 15% of women worldwide are obese and this translates into more women of childbearing age becoming obese.

In England, obesity rates among women have steadily risen affecting approximately half of the population of women of childbearing age. Obesity during pregnancy is related to newborn weight status, which leads to an increased risk of obesity in later years.

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Giant Retrovesical Ectopic Prostate Tissue: A Case Report and Review of the Literature

We report an unusual case of retrovesical ectopic prostate tissue in a 71-year-old man, whose prostate-specific antigen was 10.20 ng/ml. Transabdominal ultrasonography, pelvic computed tomography showed a heterogeneous, solid-cystic, 8 cm × 8.8 cm × 8.5 cm mass in contact with the posterior wall of the bladder.

The patient underwent a laparoscopic pelvic neoplasm resection. Pathological examination confirmed the retrovesical tumor was normal prostate tissue.

Ectopic prostate tissue is a relatively uncommon disease, and most of them were found in the lower male genitourinary tract. However, the ectopic prostate tissue suited in the retrovesical space is rare.

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New Onset of Erectile Dysfunction in a Cohort of Patients Enrolled in Active Surveillance for Low Risk Prostate Cancer

After serum Prostate Specific Antigen (PSA) concentration was introduced as a screening test in prostate disease, prostate cancer has been increasingly detected at an early stage and grade. PSA test leads to Prostate Cancer (PCa) over diagnosis and overtreatment.

To overcome overtreatment, low risk PCa patients are enrolled in AS in order to prevent overtreatment, delaying curative treatment according to neoplasm progression. The AS protocols were approved to delay radical treatment and spare treatment.

However AS can influence quality of life related to health defined as “a physical, mental, and social well-being and not merely the absence of disease”. In fact AS consists in repeating rectal examination, serial PSA evaluations and yearly repeated biopsies, that may be associated with side effects: hematuria, haemospermia, infection, anxiety and Erectile Dysfunction.

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Assessment of a Comprehensive New-Born Survival Programme in 14 Districts in the Northern and Upper East Regions of Ghana

The aim is to ascertain the effectiveness of a package of evidence-based neonatal survival interventions focusing on Home-Based Postnatal Care and Facility-Based Integrated Management of New-born and Childhood Illnesses models on reduction in neonatal mortality rate in Northern and Upper East regions of Ghana.

Method: The assessment employed a mixed method design. Baseline and end line neonatal mortality rates were estimated using the 2011 Multiple Indicator Cluster Survey and the 2014 Ghana Demographic and Health Surveys respectively, which used similar designs and analytical methods.

The qualitative component consisted of in-depth interviews with key national decision-makers, donor partners, sub-national authorities and service providers, and focus group discussions with mothers or caregivers drawn from project communities.

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A Blue Spotted Baby: A Case Report

The Mongolian spot (MS) is a congenital macula of blue-gray colour usually located on the sacrococcygeal region, but may have atypical locations such as the back and more rarely the limbs. The authors describe a case of an infant male, born from a monitored pregnancy without complications, whose skin objective examination showed a Mongolian spot occupying the entire lower back region and lower limbs with many similar spots of different sizes and locations as well as on the back of the right hand. Further physical examination appeared to be normal. 

The knowledge of normal variants is crucial in clinical practice of the family doctor, particularly in child health consultation. This atypical skin colouration arises with relative frequency in our population and although it does not seem strange in the usual location, the appearance in atypical locations can be a sign of other associated pathologies, and if they had not been observed at birth, they can be an alert for eventual child abuse. 

Separation of Motile Bovine Spermatozoa for In Vitro Fertilization by Electrical Charge

Frozen-thawed semen has been extensively used for bovine artificial insemination (AI) and in vitro fertilization (IVF) procedures. Most spermatozoa are injured during semen freezing and thawing processes leading to reduction in sperm motility and to membrane structure.

The presence of non-motile or damaged sperm in the frozen semen negatively affects semen quality; motile, morphologically normal sperm must be separated from seminal plasma components, the extender supplements and/or undesired cells, by means of a selection technique.

In cattle, higher pregnancy rates were obtained with selected sperm compared to unselected samples from the same ejaculate, when equal numbers of motile cells were used for insemination. Thus, sperm treatments to select motile spermatozoa from frozen–thawed semen are essential when in vitro fertilization (IVF) is performed in cattle.

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Pemphigoid Gestationis: A Case Report and Review of Literature

Gestational (pemphigoid gestationis, PG) is an uncommon immune system skin issue that happens amid pregnancy.

PG has a place with the pemphigoid gathering of immune system skin sicknesses that cause rankling of the skin and mucosal films.

It is an uncommon sickness with an occurrence of 1 in 50,000 pregnancies. PG ordinarily shows amid the second or third trimester with repeat in consequent pregnancies. It can be analyzed by histopathology and direct immunofluorescence which is corroborative. Systemic steroids are the backbone of treatment.

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Aging of the Male Germline: Influence of Advanced Male Age on Reproductive Outcome

The rise in life expectancy in developed countries, as well as the wish to establish a career prior to parenthood, leads numerous couples to a delayed childbearing. Advanced age at the time of pregnancy portrays clear risks, with a great majority of couples above 35 experiencing reproductive complications.

The effects of women’s age on fertility are well established, being one of the most important factors to consider when addressing fertility issues. Indeed, women over 35 have a compromised fertility, with low oocyte numbers and overall reduced quality.

This biological clock of women’s reproduction capacity restrains fertility after a certain age leading to a decreased capacity to conceive and prolonged time to achieve pregnancy.

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New Onset of Erectile Dysfunction in a Cohort of Patients Enrolled in Active Surveillance for Low Risk Prostate Cancer

After serum Prostate Specific Antigen (PSA) concentration was introduced as a screening test in prostate disease, prostate cancer has been increasingly detected at an early stage and grade. PSA test leads to Prostate Cancer (PCa) over diagnosis and overtreatment.

To overcome overtreatment, low risk PCa patients are enrolled in AS in order to prevent overtreatment, delaying curative treatment according to neoplasm progression.

The AS protocols were approved to delay radical treatment and spare treatment; however AS can influence quality of life related to health defined as “a physical, mental, and social well-being and not merely the absence of disease.

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Effects of a High Protein/Low Carbohydrate Versus a Standard Hypocaloric Diet on Weight and Cardiovascular Risk Factors

The incidence of obesity is increasing all Western Countries. This dramatically increasing in obesity prevalence has led to an important increase of investigation on adipose tissue and its role in metabolism, inflammation and other physiologic processes.

Obesity has a low grade systemic inflammation and adipose tissue is considered an active secretory organ of a new family of molecules called adipokines (for example, leptin). Leptin is a protein containing 167 amino acids, demonstrates structural similarities with cytokines and is mainly produced by white adipose tissue.

Some studies have confirmed that other tissues express leptin, including ovaries, placenta, stomach, pituitary, skeletal muscle and liver.

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The National Quality Plan and More Caesarean Sections, Less Wound Infections,more Gestational Diabetes (GDM) and Fewer Smokers in Northern Norway

The Ministry of Health and Care Service’s plan for improved maternity and delivery care was implemented in Northern Norway in March 2012. Selection criteria were standardized and economic resources allocated.

We explored the effects in a retrospective quality of care study employing data from the Medical Birth Registry of Norway (MBRN). The prior study (2009-11) was compared with the 2012-14 period. The levels of care were Midwife administered maternity units (MAMU), Departments of Obstetrics and Gynaecology (DOG) and Regional Clinics of Obstetrics and Gynaecology (RCOG).

National data on post-caesarean surgical wound infection (2009-2014) was added. Quality of care was defined as rate of multiple pregnancies, eclampsia, vacuum or forceps assisted delivery, births during transportation, caesarean section rate, post-caesarean wound infection, perineal rupture, smoking habits, body mass index (BMI), Apgar score <7, birth weight <2.5 kg and stillbirth.

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Understanding HIV Positive Women’s Experiences with Antenatal Care in Rural Maputo Province, Mozambique

The journey to motherhood among pregnant women living with HIV/AIDS is considered perilous in most of the countries of Sub- Saharan Africa. Carrying a pregnancy implies to follow biomedical norms recommended by campaigns on prevention of mother-to-child transmission (PMTCT) of HIV.

These recommendations consist of attending first antenatal care from the first trimester of the pregnancy, as well as adherence and compliance to antiretroviral therapy (ARTs) to prevent transmission of HIV during the pregnancy, as recommended by the World Health Organization and the Ministry of Health of Mozambique.

Moreover, women are recommended to give childbirth at a health facility, to adhere to ARTs for the newborn, to practise exclusive breastfeeding in the first six months of life and to adhere to lifelong ARTs for their own health.

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Pemphigoid Gestationis | A Case Report and Review of Literature

Pemphigoid gestationis is a rare autoimmune blistering disease specific to pregnancy. It is characterized by pruritic, urticarial plaques with development of tense vesicles and bullae within the lesions.

Recurrence with subsequent pregnancies are often more severe and may be associated with miscarriages, prematurity, low birth weight and rarely fetal death. We report this case of pemphigoid gestationis in view of the importance of early diagnosis and treatment for prevention of fetal risk.

Gestational (pemphigoid gestationis, PG) is an uncommon immune system skin issue that happens amid pregnancy.PG has a place with the pemphigoid gathering of immune system skin sicknesses that cause rankling of the skin and mucosal films

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Age-dependent Expression of Catspers in Human and Mice Sperm

Calcium ions play an important role in almost every aspect of cell communication and sperm function such as, maturation, motility, and acrosome reaction (AR) in many species. The voltage gated ion channels are the key part in maintaining the intracellular level of calcium in sperm cell.

Catspers are novel voltage gated Ca2+ ion channel located specifically in the principal piece of the sperm tail, controls the influx of calcium ions into the spermatozoa, important for sperm motility. The gene coding for Ca2+ channel are exclusively expressed in the testis.

As the age progresses the sperm motility detoriates and as Catsper is the gene responsible for maintaining the sperm motility it becomes important to further elucidate Catsper expression with the progression of age for which there has been not much studies reported. Previously, we suggested that the calcium level drops down with increase in age.

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Clinical and Laboratory Assessment of Supplementation with Marine Collagen Peptides and Selected Antioxidants in Men with Mild-to-Moderate Erectile Dysfunction

Erectile dysfunction (ED) remains one of the most frequent disturbances of male health with great negative impact on psychological, behavioral, and social conditions of the affected subject. Moreover, a close correlation between ED and the risk of cardiovascular diseases has recently become evident.

The search for safe and efficient approaches to combat and control ED has been growing steadily.Current pharmacological means target two major causes of nonandrogen ED revealed so far the impaired signalling from central nervous system and/or peripherally from penile tissue, to improve local endogenous metabolic pathways that control the erection process.

The drugs/supplements inducing penile smooth muscle relaxation are numerous, the best known being prostaglandin E1, NO donors, phosphodiesterase inhibitors, bioactive peptides, excitatory amino acids, and antagonists/agonists of neuro-transmitting and other receptors.

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Fibroepithelial Polyp of the Vagina with Fungal Infection

A 35-year-old woman presented with complaints of itching in the perineal region and something coming out per vaginum. A general and systemic examination was unremarkable. On per speculum examination, a pedunculated polyp measuring 2.5×1.5×0.5 cm with a stalk of 0.8 cm was seen coming out from the anterior vaginal wall.

Multiple tiny projections were present on the surface of polyp. On per vaginal examination, uterus was of normal size and bilateral fornices were free. Ultrasound examination showed normal sized uterus with endometrial thickness of 5 mm. There was no adnexal mass seen. Under local anesthesia and full aseptic conditions, polyp was excised and submitted for histopathological examination.

Microscopic examination showed a polyp lined by stratified squamous epithelium with underlying loosely arranged vascularized stroma and infiltrates of lymphocytes, plasma cells and mast cells. Stratified squamous epithelium exhibited focal koilocytic changes and focal collection of neutrophils.

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The Impact of Short Stature on the Childrens Psychology: An Examination of Child Psychology, Peer and Familial Relationships

Short stature (SS) is defined as height more than two standard deviations below the mean for age and gender. SS could be a result of organic or non-organic causes. Organic causes include: endocrine abnormalities, bone lesions, intrauterine growth retardation, chromosomal abnormalities (Dawn syndrome, Russell-silver syndrome) or other causes.

Non-organic causes include: familial short stature, malnutrition, constitutional delay of growth and adolescence. Around 2% of all children present with SS. Boys tend to come to medical attention more frequently than girls.

However, the percentage of girls with organic disease significantly exceeded that of boys. Differences in height were more pronounced around the age of 9 years. Sex was not associated with severity of short stature.

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Reproductive Behavior of Female University Students in Relation to Endocrine Regulators Concentration in Blood Plasma during Ovarian Cycle Phases

The aim of our work based on answers of Slovak women - university students that are representing an important target group, was to analyse their reproductive behaviour and opinions, because the behaviour and opinions concerning reproduction could differ significantly depending also on education.

Our goal was to analyze associations among reproductive behaviour of university student girls, their opinions and concentrations of endocrine regulators (insulin-like growth factors IGF-1, estradiol, testosterone and progesterone) in the blood serum and record their changes during the ovarian cycle.

The group under study encompassed 301 female university students aged 19 ± 1.371 years. Analysis of reproductive behaviour characteristics were based on a questionnaire method. Concentrations of the IGF-1, testosterone, estradiol and progesterone in blood plasma according to ovarian cycle phase had been set by biochemical methods and then linked with reproductive behaviour.

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Penoscrotal Incision for Implanting Penile Prosthesis

The surgical procedure of hydraulic (three-piece inflatable penile prosthesis) penile implant is a valid option in the treatment of erectile dysfunction who have not gotten results from other types of treatments.

This operation is minimally invasive because it’s done in 30 minutes; involve only 4 cm incision and few days off from work. The operation is generally carried out under regional anesthesia.

Satisfaction of patients and good quality of sexual life has been reported. Penile prosthesis does not change sensation on the skin of the penis or a man’s ability to reach orgasm. The ejaculation is not affected.

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Age-dependent Expression of Catspers in Human and Mice Sperm

Calcium ions play an important role in almost every aspect of cell communication and sperm function such as, maturation, motility, and acrosome reaction (AR) in many species. The voltage gated ion channels are the key part in maintaining the intracellular level of calcium in sperm cell.

Catspers are novel voltage gated Ca2+ ion channel located specifically in the principal piece of the sperm tail, controls the influx of calcium ions into the spermatozoa, important for sperm motility. The gene coding for Ca2+ channel are exclusively expressed in the testis.

As the age progresses the sperm motility detoriates and as Catsper is the gene responsible for maintaining the sperm motility it becomes important to further elucidate Catsper expression with the progression of age for which there has been not much studies reported.

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The Impact of Birth Preparedness on Pregnancy Outcome Findings from Lurambi Sub County, Kakamega County, Kenya

Due to inequities in functioning health systems, pregnant women in the developing world have a high risk of morbidity and mortality despite the world health organization (who) vision of universal coverage of health care.

It is estimated that the adult lifetime risk of maternal mortality in women in the sub-saharan region is 1 in 38. This figure sharply contrasts that of the developed world, which stands at 1 in 3,700. In addition, the maternal mortality ratio (mmr) in sub- saharan countries is high (510 per 100,000 live births), contributing to 62% of maternal deaths in the world.

Improvements in maternal health and reductions in maternal mortality have been slower than anticipated and despite isolated successes remain far below the mdg5 target of a 75% reduction in the maternal mortality ratio (mmr) from 1990 to 2015. However, child survival progress is accelerating. it was estimated that only 31 countries were on track to achieve the mdg4 target to reduce child mortality by two-thirds between 1990 and 2015.

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Prognostic Factors of Pregnancy and Childbirth in Adolescents

Adolescence is a period of psychological instability and immaturity of organs which may lead to risk abortions and dystocia during childbirth. Early pregnancy is still an issue of concern considering its adverse effects on adolescents’ health, education and rights as well as the precarious prognostic of unborn children.

In Benin, adolescents account for 21% of total fertility. However, few studies had been dedicated to the issue. This study aims to identify the prognostic factors of pregnancy and childbirth in adolescents at CHDU-B in Parakou. The study had been carried out in the gynecology and obstetrics unit of the Borgou Regional University Teaching Hospital located in the town of Parakou.

This research work involved the nulliparous pregnant subjects bearing a single pregnancy and under 20 years of age as regards adolescents and those aged 20 to 34 years as regards adults and who accepted to participate to the study.

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Meconium Stained Amniotic Fluid: Factors affecting Maternal and Perinatal Outcomes at Jimma University

Meconium is a black-green, odourless material first demonstrable in the fetal intestine during the third month of gestation and it results from the accumulation of debris.Passage of meconium slows down after 16 weeks and cease by 20 weeks of gestation. Almost all new-born infants who pass meconium are mature.

However, in some cases; meconium passage may be associated with umbilical cord compression or increased sympathetic inflow during hypoxia and is also a potential toxin if the fetus aspirates this particulate matter with a gasping breath in utero or when it takes its first breaths following birth.

In addition intrauterine exposure to meconium is associated with inflammation of tissues of the lung, chorionic plate and umbilical vessels and through various mechanisms may contribute to neonatal morbidity, independent of MAS.

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Andrology 2016 and Beyond

In itself, andrology specialty is rapidly progressing one that gains day after day momentum to boost and broaden its wealth of information to answer the questions of the exact nature of biological, endocrinological, genetic as well as molecular proceedings or progress taking place in andrological disorders. At the same time, it offers an ultimate solution for specific andrological problems depending on the heartfelt efforts of the scientists in all branches and their devoted inventions.

Driven by the global revolution of information and communication, there is remarkable exigency to improve men’s health status and to prolong their operational lifespan. Effective measures and programs to bring about healthy lifestyle adjustment will unquestionably add another 10 years of health adjusted and working lifespan.

Therefore, focusing on the integrated health service package, as well as on the essential health care system should be essential especially in remote areas and migrating people residences. In addition, there is a need for lifespan longitudinal studies of men to spot factors influencing the development of andrological disorders.

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Accessibility, Availability and Perceived Quality of Reproductive Health Services in Selected Urban Areas of Bangladesh: User and Non Users Perspectives

Primary healthcare has been considered as a major agenda in many national and international policies and gained enormous attention by Global leader. Following the 1994 International Conference on Population and Development (ICPD) in Cairo, emphasis was given on providing a broader range of primary healthcare (PHC) services in a package to minimize the costs.

The Essential Service Package (ESP) was targeted especially to women, children and poor, intended to offer quality services from one stop facilities that would be client oriented. Enhancing the quality of health care delivery in developing countries through provision of ESP is a key element to increased utilization of these services in the target population.In the last two decades there was a huge growth in urban population in Bangladesh.

It is a great challenge for the public sector to meet up the growing needs of health care services in urban areas of Bangladesh, particularly for the urban poor. Under the Health and Population Sector Program (HPSP), the Government of Bangladesh aimed to provide ESP package accessible through fixed site clinics that was aimed at maximizing health benefits, meeting needs of clients, strengthening service delivery, and improving health systems management.  

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Factors associated with Synchronous Endometrial and Ovarian Cancer, Review of a Case

A 54-year-old perimenopausal woman complained of abnormal uterine bleedings and lower abdominal pain for 6 months. Personal antecedents were smoking, hypertension, chronic obstruction pulmonary disease, obstructive sleep apnea, obesity (BMI 42.7 kg/m2) and nulliparity.

The first exploration showed high tumor markers (Ca125 890 UI/ml, Ca19.9 960 UI/ml) and an enlarged uterus with thickened endometrium, but the gynecological examination was unreliable.A diagnostic hysteroscopy showed an abnormal growth on the entire endometrial cavity with atypical vascularization.

Biopsy was consistent with low-grade endometrial adenocarcinoma.The pelvic magnetic resonance (MR) showed a large uterus, occupied by an endometrial carcinoma 4 mm close to the uterine serosa. There was an invasion to the cervix stromal, a left 20 cm heterogeneous and a hypovascular multiloculated adnexal mass adhered to mesosigma. No ascites or carcinomatosis were found.

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Chemotherapy for Elderly Ovarian Cancer Patients

Cancer is one of the leading causes of morbidity and mortality worldwide, with the number of new cases expected to increase over the next 2 decades. Ovarian cancer is the 6th most commonly diagnosed cancer in women, worldwide

It is estimated that there will be approximately 21,290 new cases of ovarian cancer in 2015. With an aging population, the prevalence of ovarian cancer can only be expected to increase. The most common histologic type of ovarian cancer is epithelial and standard treatment, with few exceptions, includes aggressive cytoreductive surgery followed by adjuvant chemotherapy with platinum-based compounds and a taxane.

To date, there is mounting evidence that age by itself should not influence whether a patient receives reduced chemotherapy dosing when being treated for an ovarian cancer. The purpose of this retrospective study is to report how women over 65 years of age treated at the Yale Comprehensive Cancer Center.

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Maternal and Child Health: The Perinatal Paradox in a Developing Country

Several recent studies have demonstrated the exposure of social groups to bad health conditions. That puts individuals at the risk of experiencing adverse outcomes, which includes mostly transgenerational effects.Concerning the mother’s and the newborn’s health, their socioeconomic conditions contribute to the occurrence Low Birth Weight (LBW) and preterm cases.

According to the World Health Organization (WHO), among all the births in the world, around 20.6 million (15.5%) of babies are born with LBW.Most of these cases are in developing countries (e.g. 27% in Asia against 6.4% in Europe), in which the rate of child mortality is similar to the maternal mortality, with a great incidence particularly in Africa and Asia.Although the mothers' and newborns' access to health has improved in many countries, there are still huge inequalities between developing and developed countries and also regional differences inside them, evidencing the uneven health conditions of the population.

LBW rates in developing countries have been associated with adverse socioeconomic conditions, in which there are a great number of newborns with Intrauterine Growth Restriction (IGR), while in developed countries LBW is primarily related to preterm delivery.This situation can be verified in Brazil, a medium-income developing country administratively organized in five regions with distinctive environmental, cultural and socio-economic circumstances.

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Meconium Stained Amniotic Fluid: Factors affecting Maternal and Perinatal Outcomes at Jimma University Specialized Teaching Hospital, South West Ethiopia

Meconium is a black-green, odourless material first demonstrable in the fetal intestine during the third month of gestation and it results from the accumulation of debris.Passage of meconium slows down after 16 weeks and cease by 20 weeks of gestation. Almost all new-born infants who pass meconium are mature (term).

However, in some cases; meconium passage may be associated with umbilical cord compression or increased sympathetic inflow during hypoxia and is also a potential toxin if the fetus aspirates this particulate matter with a gasping breath in utero or when it takes its first breaths following birth. In addition intrauterine exposure to meconium is associated with inflammation of tissues of the lung, chorionic plate and umbilical vessels and through various mechanisms may contribute to neonatal morbidity, independent of MAS.

Meconium stained amniotic fluid (MSAF) occurs in 12 to 20% of labouring mothers, and it is a confusing issue because it can be due to either physiologic or a hypoxic insult to the fetus. Birth depression occurs in 20 to 33% of infants born through MSAF and is likely caused by chronic asphyxia and infection that may lead to passage of meconium and fetal gasping. This suggest that meconiumstained amniotic fluid should be regarded as a symptom rather than a syndrome becoming more prevalent with increasing term and which might be associated with higher levels of infection or asphyxia.

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