A pregnancy that is prolonged may be associated with placental insufficiency, which adversely affects the fetus. Clifford described progressive stages of this dysmaturity syndrome.
Consequences of placental dysfunction:
(1) growth retardation
(2) decreased nutrition delivery, with catabolism of subcutaneous fat
(3) fetal anoxia with release of meconium
Parameters:
(1) skin
(2) meconium staining placenta and amniotic fluid (AF)
(3) meconium staining neonate
Skin
Meconium Staining Placenta and AF
Meconium Staining Neonate
Stage
normal
none
none
0
dry, cracking, wrinkled, parchment like
none
none
I
dry, cracking, wrinkled, parchment like
present, green
present, green
II
dry, cracking, wrinkled, parchment like
present, yellow-green
present with nails affected, bright yellow
III
Interpretation:
• The higher the stage the more severe the dysmaturity and the higher the risk of morbidity and mortality.
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