Meconium Staining

Subject: Midwifery II (Theory)

Overview

Meconium is a dark green liquid that is routinely passed by a newborn baby and contains mucus, bile, and epithelial cells. However, in some situations, meconium is passed while the infant is still in the womb, coloring the amniotic fluid. This might range from minor to extensive discoloration. It is regarded as significant if it is dark green or black and has a thick, tenacious appearance. Placental insufficiency, maternal hypertension and pre-eclampsia, oligohydramnios, cocaine usage, and maternal age are also risk factors. If there is substantial meconium staining during labor, there should be continuous electronic fetal monitoring. If there are indicators of fetal distress, a fetal blood sample should be taken. If the pH is 7.21, there should be an emergency delivery. Ensure that an advanced resuscitation unit and adequately trained personnel are available.

Meconium is a dark green liquid that a newborn baby passes, including mucus, bile, and epithelial cells.

However, meconium can be passed while the infant is still in the womb, coloring the amniotic fluid. The staining can range from faint to substantial. It is important if it is dark green or black and has a thick, tenacious appearance.

Risk Factors

  • Placental insufficiency
  • Maternal hypertension and pre-eclampsia
  • Oligohydramnios
  • Smoking
  • Cocaine abuse
  • Increased maternal age

Management

Intrapartum

  • If substantial meconium staining is observed during labor, continuous electronic fetal monitoring should be performed.
  • This is characterized as thick or tenacious dark green or black amniotic fluid, or any amniotic fluid containing chunks of meconium.
  • If it is safe to do so and birth is not imminent, transfer the mother to obstetric-led care.
  • A fetal blood sample should be taken if there are indicators of fetal distress. If the pH is 7.21, an emergency delivery should be made.
  • Ensure that an advanced resuscitation unit and adequately trained personnel are on hand.
  • Prior to delivery, there should be no suction.

At delivery - a healthy neonate

  • There should be no suction if the baby is in good condition (Apgar score >5, based on color, tone, heart rate, and breathing).
  • The newborn should be checked for symptoms of respiratory distress in the first hour, then every hour for the next two hours until he or she is 12 hours old.
  • Suction should be utilized in the upper airways if there are blood or meconium lumps in the oropharynx.
  • Endotracheal intubation at birth is no longer indicated in otherwise healthy, term meconium-stained newborns.
Things to remember
  • Meconium is a dark green liquid that a newborn baby passes, including mucus, bile, and epithelial cells.
  • However, meconium can be passed while the infant is still in the womb, coloring the amniotic fluid.
  • The staining can range from faint to substantial. It is important if it is dark green or black and has a thick, tenacious appearance.
  • Placental insufficiency, maternal hypertension and pre-eclampsia, oligohydramnios, cocaine usage, and higher maternal age are also risk factors.
  • If substantial meconium staining is observed during labor, continuous electronic fetal monitoring should be performed.
  • A fetal blood sample should be taken if there are indicators of fetal distress.
  • If the pH is 7.21, an emergency delivery should be made.
  • Ensure that an advanced resuscitation unit and adequately trained personnel are on hand.
Questions and Answers

Risk Factors Include:

  • Placental insufficiency.
  • Maternal hypertension and pre-eclampsia.
  • Oligohydramnios.
  • Smoking.
  • Cocaine abuse.
  • Increased maternal age.

Management

Intrapartum

  • Electronic fetal monitoring should be ongoing if considerable meconium staining is seen during labor.
  • This is described as thick, tenacious, dark green, black, or any amniotic fluid that has meconium lumps in it.
  • If it is safe to do so and the woman is not in danger of giving birth, transfer her to obstetric care.
  • A sample of the fetal blood should be taken if there are any indications of fetal distress. There should be an emergency delivery if the pH is below 7.21.
  • Make sure the advanced resuscitation unit and properly trained personnel are on hand.
  • Suction shouldn't exist before delivery.

At delivery - healthy neonate

  • There shouldn't be any suction if the infant is healthy (Apgar score >5, depending on color, tone, heart rate, and breathing).
  • In the first hour of life, the second hour, and then every two hours until the newborn is 12 hours old, the infant should be watched for any indications of respiratory distress.
  • Suction should be used to the upper airways if there is blood or if there are meconium lumps in the oropharynx.
  • Endotracheal intubation is no longer advised for term, healthy newborns who are meconium-stained at delivery.

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