Fetal Aspiration of Meconium

This week I was at the OB/Gyn ward at Cape Coast Teaching Hospital. The teams in this ward also are on duty at the Delivery Suite. The ward sees to all pregnant women with medical issues and gynecological issues. Procedures are done in the delivery suite, vaginal delivery, cesarian sections, and pregnancy termination.

While I was in the delivery suite I was able to observe an emergency C-section. The fetus had passed meconium in-utero as evidenced by the mother's meconium stain. Meconium is the first stool passed by a neonate, it consists of metabolic by-products in the intestines from gestation. If it is passed before birth it is a sign of fetal distress. The mother was also only 2 cm dilated. There was a reason to wait because the mother was very young and for her first birth to be a cesarian it means her following pregnancies would likely also be C-sections. Being so young she is likely to be pregnant again. Although, there were no other signs of fetal distress it would be a risk to wait and to just deliver the child now. The biggest fear is meconium aspiration syndrome. It is when the fetus has meconium in the lungs. This can cause a spectrum of pathological problems for the child as lung development and oxygen intake are compromised. The CS was successful and the mother and baby are on their way to recovery.

The story is not always happy. The same ward saw to the death of a woman who attempted to terminate her own pregnancy through traditional methods. Maternal mortality is 122% higher in Ghana than the US. In my opinion it is attributed to the expectation that women are virgins until marriage and the culture is still very patriarchal which makes women have lesser say in their sexual and reproductive health. All-in-all Ghana is improving its stigmas surrounding sex.... namely condoms being handed out by the bucket at the Cape Coast Festival this last weekend!