RE: [ozmidwifery] suctioning mec

[Sally Westbury]

No Benefit Seen With Suctioning During Birth of Meconium-Stained Neonates     By Roberta Friedman, PhD   SAN FRANCISCO (Reuters Health) Feb 11 - Suctioning during delivery of infants who present with meconium staining apparently does not prevent meconium aspiration syndrome. These findings, presented at the meeting of the Society for Maternal-Fetal Medicine, contradict current practice guidelines.   Lead study author Dr. Edgardo Szyld, of the Hospital Diego Paroissien in   Buenos Aires, Argentina, believes that "we should consider revising the current recommendations" of suctioning these infants during delivery.   A total of 2514 infants with meconium-stained amniotic fluid were randomized to oro- and nasopharynx suctioning or to no suctioning just before delivery of the shoulders. Of those infants suctioned, 3.5% developed meconium aspiration syndrome (MAS), as did 3.6% of those not suctioned. Five newborns died in the suctioned group, and three in the group not suctioned.   No differences between the two groups were observed in the frequency of thick meconium, C-sections or need for resuscitation.   A single study back in the 1970s was the foundation for the recommendation of suctioning when meconium staining is evident, Dr. Szyld said. Recommendations to suction, set forth by the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists (ACOG) makes the practice "widespread--and it's done around the world."   However, he said, the current study shows that suctioning before the shoulders are delivered does not prevent meconium aspiration or its complications.   "The data presented by Dr. Szyld's team provides convincing evidence that suctioning probably does not" alter outcomes, Dr. Laura E. Riley, chair of ACOG's Committee on Obstetric Practice, told Reuters Health.   "Because suctioning has been beaten into clinicians for so many years, I'm not sure the current findings are really going to change clinical practice," Dr. Riley said. "Still, I think the findings may provide some reassurance to clinicians that when meconium aspiration syndrome occurs it probably didn't have anything to do with how adequately the infant was suctioned."   While Dr. Riley believes that the researchers succeeded in showing that suctioning is probably unnecessary, she said they didn't address "whether suctioning may actually have harmful effects, such as causing facial trauma."   Sally Westbury Homebirth Midwife   Birth is as safe as life gets.   --Harriett Hartigan