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Abstract of Study that Meconium Aspiration Syndrome not Caused by Meconium

The Best Thing You Can Do for Mothers, Babies, Birth and Families is to Become Net Savvy!

I just had my mind expanded this morning by Laureen Hudson's hour long online session on how to use the internet to get a message out. Laureen's session “Creating an Online Presence," gave me a wealth of information in a short time and impressed me with how many people are out there who completely rely on the internet for their information. I needed that, and maybe you do, too.  

  - Ina May Gaskin 

 I just hung up the phone from doing the hour long session with Laureen Hudson on “Creating an Online Presence”.  Laureen’s know-how and expertise were enough to wake up even the birth oldtimers like me and Ina May to the many unused opportunities of the internet.  Laureen’s engaging and easygoing teaching style made even those scary (to me) terms like “hypertext, streaming, wordpress, technorati, feedreader and trackback” start to make sense.  Her passion is to reach the generation of young women who have not yet given birth BEFORE they fall into the black hole of aggressive obstetrics.  I came away from the class today with lots of ways to improve my website and make it more modern, usable and interesting for readers.  This class will run again this coming Friday (August 22) and I heartily recommend it.  
- Gloria Lemay


 
REGISTER NOW! SPACE IS LIMITED! 

Cost: $35 per session 

Each session will be 60 minutes in length 

Creating An Online Presence
Sunday, September 7 at 5:00 p.m. Pacific / 8:00 p.m. Eastern
Friday, September 19 at 12:00 p.m. Pacific / 3:00 p.m. Eastern
Monday, September 22 at 9:00 a.m. Pacific / 12:00 p.m. Eastern 

Search! 
This session will include a case study of Dr. Amy and how we shoot ourselves in the collective feet by visiting and commenting on her website.  (PS Hope you enjoyed the Gotcha! page from our last email!)
Sunday, October 5 at 5:00 p.m. Pacific / 8:00 p.m. Eastern
Friday, October 24 at 12:00 p.m. Pacific / 3:00 p.m. Eastern
Monday, October 27 at 9:00 a.m. Pacific / 12:00 p.m. Eastern   

Regarding meconium:(abbreviated unless under " marks)

abstract written for MIDIRS BY HANNAH HULME June 1992 Volume2, Number2

This review has 123 references and addresses the widely-held assumption that:

  1. mec in fluids=fetal distress
  2. fetus inhales mec when asphyxia causes him to gasp
  3. mec asp sym (mas) is caused by mec in fetal lungs
Conclusions:

1. mec staining occurs in 12% of all live births ..... passage is rare before 38 weeks ....30% of pregnancies over 42 weeks will be affected ... mec staining DOES NOT (articles emphasis not mine) necessarily indicate fetal distress

2. Inhalation of mec does not mean fetal asphyxia ... episodes of deep breathing are now accepted as normal fetal behavior .... If mec is in fluids, it will obviously pass into the lungs .... fetal tach can cause deep breathing in response to cord comp for example, but such behavior does not mean fetus is distressed ... mec inhalation is generally an antepartum event ... dramatic attempts to mechanically clear the baby's airways before first breath is taken are pointless.

3. mas arises as a result of intrauterine asphyxia .... smaller fluid volume ^ risk of asphyxia and therefore aspiration (#1 oligohydramnios indicates existing uteroplacental inadequacy, #2 danger of cord comp^, and #3 any mec in fluid is relatively concentrated, and therefore more readily inhaled in significant quantity ... prevention of mas should focus on identifying fetuses at risk ..i.e. oligohydramnios ... with amnioinfusion an appropriate(? mine) therapy.

Conclusion...."inhalation of meconium by an unasphyxiated infant produces only a "mild benign, self-limiting respiratory challenge". Observation may be all these babies require; aggressive suction therapy at birth is unnecessary and perhaps harmful".

"Meconium aspiration syndrome, on the other hand, is a multi-faceted disease, complicated by meconium but primarily caused by asphyxia. Distressed babies clearly require active resuscitation at birth and this generally necessitates airway clearance, although there is no convincing evidence that removal of meconium per se affects the course of the disease. Further study is required."

My procedure is to DeLee at the perineum if mec is present in fluids. I have seen no problems postnatally. Occasionally a too vigorous mom bursts the baby forth despite my attempts at stalling her pushing efforts, and still no ensuing problems. Only on one occasion where we had a meconium (light), rupture of membranes for 6 hours, oligohydramnios, downs baby was there pneumonia diagnosed at 24 hours postpartum (multiple, predisposing, underlying circumstances ??? I'd say yes!)



This Web page is referenced from another page containing related information about Meconium

 




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