DeLee suction. Does it have clinical significance?
OBJECTIVE
To evaluate the null hypothesis that there would be no difference in neonatal outcome in infants who underwent DeLee suction vs. those who underwent bulb suction when thick meconium was present. This difference was defined as a one-day difference in length of stay, two-point difference in the five-minute Apgar score or significant difference in blood gases.


METHODS
A power calculation based on a one-day length of stay found that 115 patients would be needed in each arm. A cohort of 115 consecutive deliveries with the presence of thick meconium was reviewed during each time period when DeLee suction was utilized and then matched with deliveries that used bulb suction.


RESULTS
Two hundred thirty charts were reviewed. Length of stay, one-minute Apgar score, five-minute Apgar score, blood gases, gestational age and incidence of amnioinfusion were compared. There was no significant difference in any variable. Meconium aspiration syndrome in the period studied remained stable at < 1%.


CONCLUSIONS
There was no significant clinical change in neonatal outcome with the abandonment of nasopharyngeal DeLee suction on the perineum when meconium was present. We recommend the use of bulb suction as routine obstetric practice even in the presence of thick meconium.
Dunn
T S
TS
Departments of Obstetrics and Gynecology and of Pediatrics, Division of Maternal Fetal Medicine, University of Colorado Health Sciences Center, USA. tdunn@dhha.org
McFee
J
J
Beaty
B
B
George
B
B
Galan
H L
HL
D001034:Apgar Score; D015331:Cohort Studies; D036861:Delivery, Obstetric; D023381:Endpoint Determination; D006801:Humans; D007231:Infant, Newborn; D007902:Length of Stay; D008470:Meconium; D008471:Meconium Aspiration Syndrome / Q000517:prevention & control*; D009305:Nasopharynx; D010502:Perineum; D012189:Retrospective Studies; D013396:Suction / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome