more meconium??? | allnurses

more meconium???

  1. 0 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 lightly stained mec fluid, but mod to thick particulate stuff and the babies are SICK. Was just curious if anyone else is coming across this. Wonder if this is going to be followed by the powers.

    Thanks!!
  2. Visit  babyktchr profile page

    About babyktchr

    From 'over the rainbow'; 51 Years Old; Joined Feb '05; Posts: 856; Likes: 392.

    16 Comments so far...

  3. Visit  RNLaborNurse4U profile page
    1
    Can't say that I've seen in increase in mec at all. We have the "no inductions under 39 weeks" rule as well. However, some docs will find *some* obscure/ridiculous medical reason to induce before then. We have a group that is regularly ordering fetal lung maturity studies starting at 36-37 weeks so they can induce/section them earlier and earlier. It's getting ridiculous.
    caitking likes this.
  4. Visit  caitking profile page
    1
    Quote from RNLaborNurse4U
    Can't say that I've seen in increase in mec at all. We have the "no inductions under 39 weeks" rule as well. However, some docs will find *some* obscure/ridiculous medical reason to induce before then. We have a group that is regularly ordering fetal lung maturity studies starting at 36-37 weeks so they can induce/section them earlier and earlier. It's getting ridiculous.
    Totally agree with the ridiculous inductions. I'm just a student nurse, but I have had two kids and I must say I am very very happy they put in this guideline of 39 weeks. Babes need (unless medically inappropriate) all the time they can get in there!
    EMTtoRN22 likes this.
  5. Visit  umcRN profile page
    1
    I work in a NICU not at a delivery facility so I can't say there has been an increase in mec babies but after two years of working there I can say I do not think I would want any future pregnancies to go beyond 40 weeks. Too much at stake for those kiddos. My first patient death was a 41+ weeker whose mom had gone in for decreased fetal movement, was sent home and went in for an induction 2 days later which ended up as a crash c-section for loss of fetal heart rate. We cooled her and supported her as much as we could but she herniated and her parents withdrew support. So sad to see such a big, beautiful, would have been healthy, 9lb baby girl die :-(
    Bortaz, RN likes this.
  6. Visit  LouisVRN profile page
    2
    Quote from umcRN
    I work in a NICU not at a delivery facility so I can't say there has been an increase in mec babies but after two years of working there I can say I do not think I would want any future pregnancies to go beyond 40 weeks. Too much at stake for those kiddos. My first patient death was a 41+ weeker whose mom had gone in for decreased fetal movement, was sent home and went in for an induction 2 days later which ended up as a crash c-section for loss of fetal heart rate. We cooled her and supported her as much as we could but she herniated and her parents withdrew support. So sad to see such a big, beautiful, would have been healthy, 9lb baby girl die :-(
    IDK as a mom who has had one induction at 38 weeks, for medical reasons, and one post-date pregnancy I think I would rather take my chances letting nature take its course than subject myself and my baby to an induction for non- medical reasons granted this could be because my induction was one of the most horrible experiences in my life and my son ended up in the NICU which was not anticipated.
    EMTtoRN22 and mommy2boysaz like this.
  7. Visit  QuenymamiRN profile page
    0
    My first 3 babies, were born between 38-39wks and I had no meconium. However, my 4th I was induced at 40wks 1 day and there was a mod amt of meconium. Thankfully she did fine.
  8. Visit  Elvish profile page
    1
    Neither of my kids was induced, both came on their own between 39-40 weeks and both had mec.

    I haven't noticed an increase in mec deliveries, and haven't seen any mec kids that are any sicker than what we'd previously seen, nor are they sick more often.
    Spidey's mom likes this.
  9. Visit  msAnneRN11 profile page
    0
    Wow. I was graduating nursing school when I had my first baby induced at almost 41 weeks with moderate amt of meconium plus oligohydramnios! Thankfully he was fine


    Anne
  10. Visit  twentyyears profile page
    2
    Quote from babyktchr
    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 lightly stained mec fluid, but mod to thick particulate stuff and the babies are SICK. Was just curious if anyone else is coming across this. Wonder if this is going to be followed by the powers.

    Thanks!!
    I do chart review for my hospital in Michigan. Michigan is involved in a project called Keystone through the Michigan Hospital Association. We have seen an increase in Meconium but our nicu admissions for late preterm infants has greatly decreased. We have had not NICU admissions for mec aspiration.
    rangerlil and mommy2boysaz like this.
  11. Visit  nurselinds86 profile page
    0
    I am working in a hospital that is taking part in the 39+ weeks initiative too and I haven't noticed an increase in meconium babies yet, thankfully. Our OBs are not thrilled about the change however and they are finding obscure reasons to induce early, or they will have the pt come in the evening for cytotec when they are 38.6 weeks so that next morning they are 39.0 and they can start pit. They just can't wait that 12 hours!
  12. Visit  CanadianGirl79 profile page
    0
    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....
  13. Visit  NurseNora profile page
    0
    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.
  14. Visit  LLLovely profile page
    0
    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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