title: [Management of newborns with meconium-stained amniotic fluid: prospective evaluation of practice].
abstract: OBJECTIVE
  Regional guideline for immediate tracheal suctioning (ITS) in vigorous and non-vigorous infants born through meconium-stained amniotic fluid (MSAF) has been established in 2003. The objective of this study was to evaluate guideline application.
  
  
  METHODS
  Prospective cohort.
  
  
  METHODS
  The first part of the study was a short survey about ITS practices in maternity hospitals then, management and early evolution of babies born through particulate MSAF was evaluated by questionnaire.
  
  
  RESULTS
  Among 6761 neonates, 199 (3%) were born with MSAF. Early clinical evaluation showed 52 (26%) non-vigorous neonates; 22 of them (42%) have had an ITS. One hundred and forty-seven neonates were vigorous (74%); 27 of them (18%) have had an ITS. Implementation of recommendations in non-vigorous babies was better in maternities of level III, while they were lower in maternities of level IIA for vigorous babies. Among 52 non-vigorous children, eight had a meconium aspiration syndrome (MAS), including five who had an ITS. One MAS occurred in vigorous babies but infection could not be excluded.
  
  
  CONCLUSIONS
  Recommendations for ITS were implemented in 70% of cases but only in 42% of cases in non-vigorous babies. We have to improve formation and circulation of new recommendations.
authors.affiliation: Unité de réanimation pédiatrique et néonatale, unité de brûlés pédiatriques, département d'anesthésie-réanimation, centre hospitalo-universitaire Nord, Assistance publique-Hôpitaux de Marseille, faculté de médecine de Marseille, université de la Méditerranée, chemin des Bourrelys, 13915 Marseille cedex 20, France. fabrice.michel@ap-hm.fr
authors.forename: F
authors.initials: F
authors.lastname: Michel
authors.forename: C
authors.initials: C
authors.lastname: Nicaise
authors.forename: T
authors.initials: T
authors.lastname: Camus
authors.forename: J-N
authors.initials: JN
authors.lastname: Di-Marco
authors.forename: L
authors.initials: L
authors.lastname: Thomachot
authors.forename: R
authors.initials: R
authors.lastname: Vialet
authors.forename: C
authors.initials: C
authors.lastname: Martin
authors.forename: P
authors.initials: P
authors.lastname: Lagier
mesh_terms: D000653:Amniotic Fluid; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000628:therapy*; D008297:Male; D008470:Meconium; D011446:Prospective Studies; D013396:Suction