Meconium deliveries

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What is your protocall for mec deliveries? Who attends?

I have a hair up my butt after a busy day of running to thick, thin, terminal mec deliveries all day! I go with a resident, maybe two and as I'm standing there I wonder what do they do in hospitals with no NICU? I mean 99% of the time it is OK, thank goodness. But I'm a little peeved that I have to drop everything to run and pretty much hand a doctor a mec trap.

I work at a hospital that does about 30-40 deliveries a month. We also do not have a NICU. OB suctions on the perimeum and the nsy nurse calls RT to attend. The OB decides if he/she wants the Ped there. RT views the cord and suctions, if bad, with ped there. We are also all NRP certified. If really bad, we stablize and ship to a facility with a NICU.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

WE do about 65-70/mo here. If mec is NON-particulate and thin, we just have nursery, labor nurse, and OB attending delivery. If mec is particulate, thin, or accompanied by a NON-reassuring strip, we call for a PED to attend the delivery. We have no NICU either; just a level 2 nursery. If they show any signs of crumping, they go to the level 3 facility about 20 miles up the road.

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Our docs don't hardly ever do amnioinfusions, even if we have really thick mec they don't do them, but I have worked PRN at a hospital that does amnioinfusions for every pt that has mec , so.....

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Specializes in NICU.
Originally posted by RMH

Hopefully this isn't a stupid question, and it could pertain to mec deliveries.. Is anyone doing amnioinfusions anymore, and if so in what situations?? Thanks for any info. RMH

Some of our docs do amnioinfusions for thick mec, and I believe it does make a difference.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

we do amnioinfusions for all particulate or thick mec and make sure ped is there to visualize cords and suction/intubate. we also have cardio on standby for cord gases and assistance for ventilation if needed

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Almost two years ago, I was preggers and started leaking green-tinged fluid. Hightailed it to the hospital (80 miles away) and was admitted, watched for awhile, pit induction started, no cervical changes, more thick mec, amnioinfused, decels started and rushed off to surgery. My son went to the NICU for a couple of hours (general nursery was very full). He is fine and will be two on July 22. My nurse said they do amnioinfusions for thick mec - pretty standard policy. The nurses are trained and certified and a nurse did my amnioinfusion.

steph

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We do amnioinfusions for thick/mod mec and occasionally for deep variable decels.

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1- WHO ATTENDS MEC DELIVERIES?

400+/month unit: we call NICU APN to visualize and suction for thick mec

we also call NICU to standby if we've seen NO FLUID...just in case!

2- AMNIOINFUSIONS

75% docs do this for thick mec IF pt is

*** remember to look for returning fluid....

another hospital had done amnioinfusion w/o ANY return of

fluid ever charted....and pt ended up with UTERINE RUPTURE!

Hugs

haze

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Hi...I work Labor and Delivery at night also....Well, I work at a hospital that does anywhere from 1000 - 1400 deliveries a month! So we see plenty of meconium deliveries...For all meconium deliveries, a NICU team is present.

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We do about 300-400 deliveries a month. We call the Nicu team(RN and RT) to all mec deliveries. I agree most of the time there are no problems but when there are problems they are really bad. I have had a great strip with thin mec and have a really bad baby on the outside.

We rarely do amnioinfusion unless the strip looks bad and the doc is trying to avoid a C-Section.

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