A nurse is caring for a post-term newborn who has meconium staining on the nails and umbilical cord.
What is the most likely cause of this finding?
A.
The newborn has a bowel obstruction.
B.
The newborn has a congenital anomaly.
C.
The newborn experienced fetal distress.
D.
The newborn has an infection.
The Correct answer and Explanation is:
The correct answer is C. The newborn experienced fetal distress.
Explanation:
Meconium staining of the nails and umbilical cord in a post-term newborn is often indicative of fetal distress that occurred in utero. Meconium, which is the newborn’s first stool, is typically passed while still in the womb. Its presence in amniotic fluid is a common finding in cases of fetal distress and can be attributed to various factors.
Fetal Distress:
When the fetus experiences distress, such as reduced oxygenation or poor blood flow, it can lead to the passing of meconium into the amniotic fluid. This is because fetal stress can cause relaxation of the anal sphincter, allowing the meconium to be released. The meconium can then be deposited on the skin, nails, and umbilical cord. This situation often arises in cases of prolonged labor or situations where the fetus is compromised.
Post-Term Infants:
In post-term infants (those born after 42 weeks of gestation), the risk of meconium staining is higher due to the increased likelihood of fetal stress and the longer duration the fetus is exposed to potential stressors. The older the fetus, the more time there is for potential complications to develop, including the risk of meconium staining.
Other Options:
- Bowel Obstruction (A): While bowel obstruction could potentially lead to meconium-related issues, it is not a typical cause of meconium staining on the nails and umbilical cord. This condition would generally present with different symptoms, such as abdominal distension and feeding difficulties, rather than staining of the umbilical cord or nails.
- Congenital Anomaly (B): Congenital anomalies may cause various issues but are not directly associated with meconium staining of the nails and umbilical cord.
- Infection (D): Infections in newborns might cause other symptoms such as fever or lethargy but are not typically associated with meconium staining.
Therefore, meconium staining in this context is most commonly related to fetal distress, which is consistent with the passage of meconium into the amniotic fluid and subsequent staining of the newborn’s nails and umbilical cord.