Biomaterial Database

A selective aggressive approach to the neonate exposed to meconium-stained amniotic fluid. 1996

T C Peng, and G R Gutcher, and J P Van Dorsten

Department of Obstetrics and Gynecology, Medical College of Virginia/ Virginia Commonwealth University, Richmond, USA.

OBJECTIVE We attempted to determine the effect on meconium aspiration syndrome from a selective approach of neonatal endotracheal intubation in meconium-exposed fetuses. METHODS All pregnancies delivered at the Medical College of Virginia in 1990 were included. Meconium was noted at membrane rupture and qualified as thick, moderate, or thin. Neonates underwent suctioning with a DeLee device at delivery. They were observed without endotracheal intubation if they fulfilled the following criteria: vaginal delivery, gestational age > 37 weeks, birth weight > 2500 gm, and anticipated Apgar score > or = 8 at 1 minute. RESULTS Of 4289 deliveries, 659 were exposed to meconium and 48% of infants were intubated. Birth weights, gestational ages at delivery, and umbilical arterial pH were similar between intubated and nonintubated neonates. Neonatal intensive care unit admissions were significantly higher in intubated neonates. All 9 neonates diagnosed with meconium aspiration syndrome were intubated at birth. CONCLUSIONS Utilization of this protocol resulted in reduction of neonatal intubation. Meconium aspiration syndrome did not occur in the nonintubated group.

UI	MeSH Term	Description	Entries
D007231	Infant, Newborn	An infant during the first 28 days after birth.	Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D007442	Intubation, Intratracheal	A procedure involving placement of a tube into the trachea through the mouth or nose in order to provide a patient with oxygen and anesthesia.	Intubation, Endotracheal,Endotracheal Intubation,Endotracheal Intubations,Intratracheal Intubation,Intratracheal Intubations,Intubations, Endotracheal,Intubations, Intratracheal
D008471	Meconium Aspiration Syndrome	A condition caused by inhalation of MECONIUM into the LUNG of FETUS or NEWBORN, usually due to vigorous respiratory movements during difficult PARTURITION or respiratory system abnormalities. Meconium aspirate may block small airways leading to difficulties in PULMONARY GAS EXCHANGE and ASPIRATION PNEUMONIA.	Aspiration, Meconium,Meconium Aspiration,Meconium Inhalation,Aspiration Syndrome, Meconium,Syndrome, Meconium Aspiration
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000653	Amniotic Fluid	A clear, yellowish liquid that envelopes the FETUS inside the sac of AMNION. In the first trimester, it is likely a transudate of maternal or fetal plasma. In the second trimester, amniotic fluid derives primarily from fetal lung and kidney. Cells or substances in this fluid can be removed for prenatal diagnostic tests (AMNIOCENTESIS).	Amniotic Fluid Index,Amniotic Fluid Indices,Amniotic Fluids,Fluid Index, Amniotic,Fluid Indices, Amniotic,Fluid, Amniotic,Fluids, Amniotic,Index, Amniotic Fluid,Indices, Amniotic Fluid
D013396	Suction	The removal of secretions, gas or fluid from hollow or tubular organs or cavities by means of a tube and a device that acts on negative pressure.	Aspiration, Mechanical,Drainage, Suction,Aspirations, Mechanical,Drainages, Suction,Mechanical Aspiration,Mechanical Aspirations,Suction Drainage,Suction Drainages,Suctions
D015931	Intensive Care, Neonatal	Continuous care and monitoring of newborn infants with life-threatening conditions, in any setting.	Infant, Newborn, Intensive Care,Neonatal Intensive Care,Care, Neonatal Intensive