الفهرس 
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Abstract
Meconium is a common finding in amniotic fluid and placental specimens, particularly in the term or post-term pregnancy and meconium-stained amniotic fluid (MSAF) is noted in 10 to 15% of all deliveries Approximately 3 to 4% of meconium-stained infants will develop the meconium aspiration syndrome (MAS). The mechanism of meconium passage in the term and post-term fetus is hotly debated and probably there are variable and complex factors leading to the event. There are two prevailing and possibly compatible theories. One is that normal maturation of the gastrointestinal tract results in meconium passage and the alternate hypothesis is that pathologic processes, such as stress via hypoxia or infection, can trigger meconium passage. Nucleated red blood cells (NRBCs) are immature erythrocytes rarely found circulating in older children they are commonly found in the peripheral blood of newborns at birth and theire count varies widely at birth but is rarely greater than 10 in normal neonates. Nucleated red blood cells production is thought to be driven primarily by the interplay of hypoxia and erythropoietin (EPO) synthesis that EPO increases erythroid production and releases immature forms of erythrocytes into the peripheral circulation in response to hypoxia. Aim of the work: The aim of this study is to found out the relationship between meconium stained amniotic fluid and NRBC. Patients and methods: This study include 100 single live-born infants of 37 to 41 6/7 weeks’ gestation divided into two groups . Group A (Patient): Consist of 50 full term neonates with normal pregnancy and uncomplicated delivery and have meconium stained amniotic fluid.They were 21 males and 29 females. Group B (controls group ): Consist of 50 full term neonates with clear amniotic fluid. They were 15 males and 35 females. All neonates included in the study were subjected to: • Full perinatal history. • Complete clinical assessment. • Investigation included: blood smear and manual microscopy done to count NRBC per 100 WBC. The results: of the present study showed: • Number of NRBCs/100WBCs was significantly increased in muconium stained babies. • Mode of delivery was not significantly associated with increased NRBCs/100WBCs. • The frequency of muconium staining did not significantly differ as regard sex. • Increased gestational age was significantly associated with MSAF. • Apgar 1 minute and Apgar 5 minute was significantly lower in neonates with muconium stained amniotic fluid. • Significant negative correlation exists between NRBCs/100WBCs and apgar scores at 1 and 5 minutes. • Significant positive correlation exists between Gestational age of cases and NRBCs/100WBCs level. • The level 15.5 NRBCs/100WBCs is a cutoff point for NRBCs/100WBCs as a predictor for admission in all cases. Conclusion: • Neonates with MSAF have significantly higher NRBCs/100WBCs compared to non meconium stained newborn. • At level 15 NRBCs/100WBCs or more, newborn either develop meconium aspiration or meconium aspiration syndrome .