Document Detail

Meconium-stained amniotic fluid and respiratory complications: impact of selective tracheal suction.
MedLine Citation:
PMID:  8272313     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine prospectively the incidence of several pulmonary diagnoses among infants born through clear or meconium-stained amniotic fluid (AF) managed by a selective approach to tracheal intubation. METHODS: All live births greater than 36 weeks' gestation occurring between January 1990 and December 1992 were included. Diagnostic criteria for several respiratory disorders were determined prospectively and monitored. Infants with light meconium and vigorous infants with moderate to thick meconium were selectively not suctioned. A control group of infants with clear AF matched for gestational age and year of birth was randomly selected for comparison. The incidence and severity of respiratory disease were compared between the groups. RESULTS: Of 4938 live births, 799 (16%) had meconium-stained AF (light, 334; moderate to thick, 465). Compared to 211 infants with moderate to thick meconium selectively not suctioned, 196 suctioned infants had significantly greater rates of abnormal fetal heart rate (FHR) patterns, fetal acidosis, low Apgar scores at 5 minutes, need for resuscitation, and neonatal intensive care unit admission. Meconium aspiration syndrome was significantly more common in suctioned infants as compared to those selectively not suctioned, those with light meconium, and those with clear fluid (11 versus 3 versus 0 versus 0%; P < .01). The need for ventilator or oxygen support was similar between infants with clear fluid, lightly stained fluid, and moderate to thick fluid who were selectively not suctioned, but was significantly greater among suctioned infants (P < .01). CONCLUSIONS: We conclude that a selective approach to tracheal intubation and suction of infants with meconium-stained AF was not associated with increased pulmonary morbidity or mortality. Postnatal management of neonates at greatest risk of meconium aspiration syndrome does not necessarily prevent adverse pulmonary outcome.
B A Yoder
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  83     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  1994 Jan 
Date Detail:
Created Date:  1994-01-28     Completed Date:  1994-01-28     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  77-84     Citation Subset:  AIM; IM    
Department of Pediatrics, Wilford Hall United States Air Force Medical Center, Lackland AFB, Texas.
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MeSH Terms
Amniotic Fluid*
Infant, Newborn
Intubation, Intratracheal*
Lung Diseases / epidemiology*,  etiology,  prevention & control
Meconium Aspiration Syndrome / complications,  epidemiology,  therapy*
Prospective Studies
Suction / methods

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