[Management of newborns with meconium-stained amniotic fluid: prospective evaluation of practice].
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.
Michel
F
F
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
Nicaise
C
C
Camus
T
T
Di-Marco
J-N
JN
Thomachot
L
L
Vialet
R
R
Martin
C
C
Lagier
P
P
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