more meconium??? - page 2

by babyktchr 4,447 Views | 16 Comments

Just wondering...since ACOG as put out the no elective induction before 39 week ruling, has anyone else seen an increase in meconium? We see a lot more 41 weekers now, and we have had a run of meconium babies and not the demure... Read More


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    Hmmm...there DOES seem to be more mec at delivery these days...I'm gonna start paying attention to whether or not mom was induced....
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    Babies are designed to hold 40 weeks worth of meconium. After that, they tend to have stained fluid, but not the thick, particulate kind that leads to problems.My hospital has been not doing inductions before 39 weeks three years or so. We have so many less babies with temp, sugar, and feeding problems than we used to have.Since most of our docs induce at 39 weeks, I still don't see that much meconium. But watch, most 40+ week babies will have uncomplicated meconium staining.
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    Not waiting here. Admitted a chronic HTN tonight at 36+6, at midnight the pit started for induction. She does not have pre-E, baby is fine, her pressures have been primarily borderline, but we're going to have a late preterm baby this morning. She is on labetalol only. To me, we could have added nifedipine to see if her pressures came down and given the baby more time, but I don't make the calls.

    I would have to check, but my recollection from the NRP update is that meconium is really not a big concern anymore. Amnioinfusion for mec is no longer considered a treatment because it doesn't improve outcomes. Most mec babies are fine. I think it's interesting that the OP is seeing babies with mec who are very sick. I wonder what else is going on with them?
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    Quote from LLLovely

    I would have to check, but my recollection from the NRP update is that meconium is really not a big concern anymore. Amnioinfusion for mec is no longer considered a treatment because it doesn't improve outcomes. Most mec babies are fine. I think it's interesting that the OP is seeing babies with mec who are very sick. I wonder what else is going on with them?
    I agree with you. I wonder how often these patients with "sick" babies are receiving vag exams during labor? How long is their water ruptured? Are any of these babies also GBS +? None of that is related to mec stained fluid. Interesting...
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    The "sick" babies that I am referring to are mec aspiration pneumonia babies. In this specific facility I have just noticed a high incidence of thick nasty meconium and these babies having mec aspiration pnemonia.... not GBS or other related infections that cause sepsis. I would've mentioned that if that were the case.

    When I wrote this originally, we had gone thru two weeks where almost every baby had meconium, and not the demure thin kind, but horrible pea soup kind. We sent 4 kids to the NICU with respiratory issues, then requiring vents for pneumonia related to aspiration. Thankfully that has resolved since then.
    Elvish likes this.
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    This brings me to wonder, food for though persay, was the mec a result of postdates (40+1 not really postdates but you get the point) OR a result of the induction. I'm going with induction and the stress it puts on mom and baby.
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    When we moved to 41+3 for induction as per SOGC guidelines in Canada we saw waaaaay less inductions, more spontaneous and successful labours, a small increase in mec maybe but definitely no more complications. My last two hospitals wouldn't even suction for mec if baby was vigorous as per our guidelines--those babies stayed skin to skin at delivery.


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