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In 1883 Dr. Ahlfeld reported "Jaundice in late pregnancy", which was not caused by viral, bacterial hepatitis, gall stone or any other known disease with symptoms of pruritus and jaundice. Fetal prognosis of the mother suffering from the disease was poor by prematurity or FDIU., etc. hyperbilirubinemia is the important laboratory finding of the disease, "Jaundice in late pregnancy". In 1971 Dr. Willoughby stressed the correlation between the hyperbilirubinemia in late pregnancy, meconium staining and fetal prognosis. Even though jaundice and any other symptoms were not noticed, hyperbilirubinemia was detected in 10.5% of pregnant women during last trimester.2) We have studied 167 pregnant women from 32 weeks to 44 weeks of gestation for the examination of correlation between hyperbilirubinemia, meconium staining, fetal prognosis, obstetrical complication, and perinatal mortality. Bilirubin level of cord was also examined and compaired with neonatal morbidity. 5 ml. of blood sample was collected from the pregnant women and bilirubin level was checked in Evelyn-Malloy method. The same procedure was done for the checking cord blood bilirubin. The result obtained from this study was as follows: 1. The incidence of hyperbilirbilrubinemia among 167 pregnant women was 9.6%. 2. The frequency of meconium staining was 28.2% of 167 pregnant women. 3. Breaking down the 167 cases into 3 groups, A(below 0.79mg%), B(0.80-1.0.09mg%), and C (above 1.10mg%), according to the serum bilirubin level, the incidence of meconium staining was 25.9% in group A, 29.1% in group B, 43.7% in group C. 4. The incidence of obsterical complication was 62.5% in the group with meconium staining and 44.7% in the group without meconium staining. 5. The percentage of fetal distress was 27.1% in the group with meconium staining and 4.2% in the without meconium staining. 6. In the group with hyperbilirubinemia and meconium staining the incidence of fetal distress was 42.9%. 7. Because of few cases of perinatal death, no conclusion was made for the searching correlation between hyperbilirubinemia, meconium staining and perinatal mortality. No clearly defined knowledge is presented for the mechanism of hyperbilirubinemia in late pregnancy and the relationship between hyperbilirubinemia, meconium staining and fetal distress. Recently steroid (especially estrogen) from the placenta is suspected for cause of the maternal hyperbilirubinemia. Itis not known whether the maternal underlying disease which causes maternal hyperbilirubinemia influences to the fetus or any factor which causes meconium staining and fetal distress makes the maternal hyperbilirubinemia. Routine check of the pregnant women during last trimester for hyperbilirubinemia is recommended, because hyperbilirubinemia may be a poor fetal prognosis.
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