Re: [ozmidwifery] Castor oil
I have been watching this discussion re mec liquor and perineal suction. Anne, could you please give reference to your research that does not support this practice? thank you. marcia - Original Message - From: Anne Clarke To: ozmidwifery@acegraphics.com.au Sent: Friday, February 18, 2005 9:50 AM Subject: Re: [ozmidwifery] Castor oil Dear Katrina, It seems that almost everyone does suction at the peri with mec. liq. but the resarch does not support this routine procedure. Regards, Anne Clarke Brisbane - Original Message - From: Ceri Katrina To: ozmidwifery@acegraphics.com.au Sent: Thursday, February 17, 2005 3:23 PM Subject: Re: [ozmidwifery] Castor oil Hi AnneAre these articles on Cochrane? I had a lady the other day I was supporting and helping birth, and there was mec liquor, thin, but wen to thick right at the end, and the midwife I was working with suctioned at the peri, I had no idea it was not the thing to doThanksKatrinaOn 16/02/2005, at 3:13 PM, Anne Clarke wrote: Mec. liq. is not the end of the world, especially if the mother is overdue and there is no signs of fetal distress. Depending on your workplace the mother needs to negotiatefor intermittent electronic fetal monitoring (if you have to do it at all) and no suction of the baby at birth as the evidence does not support this procedure if done purelyto reduce mec. aspriation. If a baby is going to have mec. aspiration suctioning of the oro-nasal pharynx is not going to help and doesn't reduce the risk.
Re: [ozmidwifery] Castor oil
Sorry for butting in, but just found this quickly in my saved file, thought it might clarify current findings... Tania Oropharyngeal and nasopharyngeal suctioning of meconium-stained neonatesbefore delivery of their shoulders: multicentre, randomised controlledrial . ARTICLEThe Lancet, Volume 364, Issue 9434, 14 August 2004, Pages 597-602Nestor E Vain, Edgardo G Szyld, Luis M Prudent, Thomas E Wiswell, Adriana MAguilar and Norma I VivasAbstractBackgroundMeconium aspiration syndrome (MAS) is a life-threatening respiratorydisorder in infants born through meconium-stained amniotic fluid (MSAF).Although anecdotal data concerning the efficacy of intrapartum oropharyngealand nasopharyngeal suctioning of MSAF are conflicting, the procedure iswidely used. We aimed to assess the effectiveness of intrapartum suctioningfor the prevention of MAS.MethodsWe designed a randomised controlled trial in 11 hospitals in Argentina andone in the USA. 2514 patients with MSAF of any consistency, gestational ageat least 37 weeks, and cephalic presentation were randomly assigned tosuctioning of the oropharynx and nasopharynx (including the hypopharynx)before delivery of the shoulders (n=1263), or no suctioning before delivery(n=1251). Postnatal delivery-room management followed Neonatal ResuscitationProgram guidelines. The primary outcome was incidence of MAS. Cliniciansdiagnosing the syndrome and designating other study outcomes were masked togroup assignment. An informed consent waiver was used. Analysis was byintention to treat.Findings18 infants in the suction group and 15 in the no suction group did not meetentry criteria after random assignment. 87 in the suction group were notsuctioned, and 26 in the no suction group were suctioned. No significantdifference between treatment groups was seen in the incidence of MAS (52[4%] suction vs 47 [4%] no suction; relative risk 0·9, 95% CI 0·6-1·3), needfor mechanical ventilation for MAS (24 [2%] vs 18 [1%]; 0·8, 0·4-1·4),mortality (9 [1%] vs 4 [0·3%]; 0·4, 0·1-1·5), or in the duration ofventilation, oxygen treatment, and hospital care.InterpretationRoutine intrapartum oropharyngeal and nasopharyngeal suctioning ofterm-gestation infants born through MSAF does not prevent MAS. Considerationshould be given to revision of present recommendations - Original Message - From: Marcia To: ozmidwifery@acegraphics.com.au Sent: Saturday, February 19, 2005 1:08 PM Subject: Re: [ozmidwifery] Castor oil I have been watching this discussion re mec liquor and perineal suction. Anne, could you please give reference to your research that does not support this practice? thank you. marcia - Original Message - From: Anne Clarke To: ozmidwifery@acegraphics.com.au Sent: Friday, February 18, 2005 9:50 AM Subject: Re: [ozmidwifery] Castor oil Dear Katrina, It seems that almost everyone does suction at the peri with mec. liq. but the resarch does not support this routine procedure. Regards, Anne Clarke Brisbane - Original Message - From: Ceri Katrina To: ozmidwifery@acegraphics.com.au Sent: Thursday, February 17, 2005 3:23 PM Subject: Re: [ozmidwifery] Castor oil Hi AnneAre these articles on Cochrane? I had a lady the other day I was supporting and helping birth, and there was mec liquor, thin, but wen to thick right at the end, and the midwife I was working with suctioned at the peri, I had no idea it was not the thing to doThanksKatrinaOn 16/02/2005, at 3:13 PM, Anne Clarke wrote: Mec. liq. is not the end of the world, especially if the mother is overdue and there is no signs of fetal distress. Depending on your workplace the mother needs to negotiatefor intermittent electronic fetal monitoring (if you have to do it at all) and no suction of the baby at birth as the evidence does not support this procedure if done purelyto reduce mec. aspriation. If a baby is going to have mec. aspiration suctioning of the oro-nasal pharynx is not going to help and doesn't reduce the risk.
Re: [ozmidwifery] Castor oil
Meconium stained liquor rarely causes a problem. Thick or particulate meconium can cause MAS. Until there is clearer research evidence I will be suctioning on the peri for thick mec. The issue is that if the baby in utero has been asphyxiated and passes meconium and then gasps, which he is likely to do if the asphyxia is severe. He may inhale mec at that point and nothing we do at or post birth will retrieve that meconium. Thethorny issue is whether the baby passed the mec as a result ofpathological hypoxaemia or did he open his bowels because he ismature and has a ready response to low oxygen levels however slight and transient.Cord compression is common in all pregnancies and as the baby nears term the liquor production decreases slowly making cord compression more likely. A 42 weeker will pass mec very readily and a high % have MSL at the onset of labour. A quick check with a CTG is required. No evidence of hypoxaemia...fine, off with the monitor and on with the labour. Thanks for the reference. ECPC addresses this topic but it is about due for a new edition. Cheers jenny Jennifer Cameron FRCNA FACMProMid Professional Midwifery Education Service0419 528 717 - Original Message - From: Tania Smallwood To: ozmidwifery@acegraphics.com.au Sent: Saturday, February 19, 2005 12:25 PM Subject: Re: [ozmidwifery] Castor oil Sorry for butting in, but just found this quickly in my saved file, thought it might clarify current findings... Tania Oropharyngeal and nasopharyngeal suctioning of meconium-stained neonatesbefore delivery of their shoulders: multicentre, randomised controlledrial . ARTICLEThe Lancet, Volume 364, Issue 9434, 14 August 2004, Pages 597-602Nestor E Vain, Edgardo G Szyld, Luis M Prudent, Thomas E Wiswell, Adriana MAguilar and Norma I VivasAbstractBackgroundMeconium aspiration syndrome (MAS) is a life-threatening respiratorydisorder in infants born through meconium-stained amniotic fluid (MSAF).Although anecdotal data concerning the efficacy of intrapartum oropharyngealand nasopharyngeal suctioning of MSAF are conflicting, the procedure iswidely used. We aimed to assess the effectiveness of intrapartum suctioningfor the prevention of MAS.MethodsWe designed a randomised controlled trial in 11 hospitals in Argentina andone in the USA. 2514 patients with MSAF of any consistency, gestational ageat least 37 weeks, and cephalic presentation were randomly assigned tosuctioning of the oropharynx and nasopharynx (including the hypopharynx)before delivery of the shoulders (n=1263), or no suctioning before delivery(n=1251). Postnatal delivery-room management followed Neonatal ResuscitationProgram guidelines. The primary outcome was incidence of MAS. Cliniciansdiagnosing the syndrome and designating other study outcomes were masked togroup assignment. An informed consent waiver was used. Analysis was byintention to treat.Findings18 infants in the suction group and 15 in the no suction group did not meetentry criteria after random assignment. 87 in the suction group were notsuctioned, and 26 in the no suction group were suctioned. No significantdifference between treatment groups was seen in the incidence of MAS (52[4%] suction vs 47 [4%] no suction; relative risk 0·9, 95% CI 0·6-1·3), needfor mechanical ventilation for MAS (24 [2%] vs 18 [1%]; 0·8, 0·4-1·4),mortality (9 [1%] vs 4 [0·3%]; 0·4, 0·1-1·5), or in the duration ofventilation, oxygen treatment, and hospital care.InterpretationRoutine intrapartum oropharyngeal and nasopharyngeal suctioning ofterm-gestation infants born through MSAF does not prevent MAS. Considerationshould be given to revision of present recommendations - Original Message - From: Marcia To: ozmidwifery@acegraphics.com.au Sent: Saturday, February 19, 2005 1:08 PM Subject: Re: [ozmidwifery] Castor oil I have been watching this discussion re mec liquor and perineal suction. Anne, could you please give reference to your research that does not support this practice? thank you. marcia - Original Message - From: Anne Clarke To: ozmidwifery@acegraphics.com.au Sent: Friday, February 18, 2005 9:50 AM Subject: Re: [ozmidwifery] Castor oil Dear Katrina, It seems that almost everyone does suction at the peri with mec. liq. but the resarch does not support this routine procedure. Regards, Anne Clarke Brisbane - Original Message - From: Ceri Katrina To: ozmidwifery@acegraphics.com.au Sent: Thursday, February 17, 2005 3:23 PM Subject: Re: [ozmidwifery] Castor oil Hi AnneAre these articles on Cochrane? I
Re: [ozmidwifery] Castor oil
Dear Katrina, It seems that almost everyone does suction at the peri with mec. liq. but the resarch does not support this routine procedure. Regards, Anne Clarke Brisbane - Original Message - From: Ceri Katrina To: ozmidwifery@acegraphics.com.au Sent: Thursday, February 17, 2005 3:23 PM Subject: Re: [ozmidwifery] Castor oil Hi AnneAre these articles on Cochrane? I had a lady the other day I was supporting and helping birth, and there was mec liquor, thin, but wen to thick right at the end, and the midwife I was working with suctioned at the peri, I had no idea it was not the thing to doThanksKatrinaOn 16/02/2005, at 3:13 PM, Anne Clarke wrote: Mec. liq. is not the end of the world, especially if the mother is overdue and there is no signs of fetal distress. Depending on your workplace the mother needs to negotiatefor intermittent electronic fetal monitoring (if you have to do it at all) and no suction of the baby at birth as the evidence does not support this procedure if done purelyto reduce mec. aspriation. If a baby is going to have mec. aspiration suctioning of the oro-nasal pharynx is not going to help and doesn't reduce the risk.
Re: [ozmidwifery] Castor oil
Hi Anne Are these articles on Cochrane? I had a lady the other day I was supporting and helping birth, and there was mec liquor, thin, but wen to thick right at the end, and the midwife I was working with suctioned at the peri, I had no idea it was not the thing to do Thanks Katrina On 16/02/2005, at 3:13 PM, Anne Clarke wrote: Mec. liq. is not the end of the world, especially if the mother is overdue and there is no signs of fetal distress. Depending on your workplace the mother needs to negotiate for intermittent electronic fetal monitoring (if you have to do it at all) and no suction of the baby at birth as the evidence does not support this procedure if done purely to reduce mec. aspriation. If a baby is going to have mec. aspiration suctioning of the oro-nasal pharynx is not going to help and doesn't reduce the risk.
[ozmidwifery] Castor oil
Hi, Just wondering if anyone has any info on side effects of women taking castor oil (in relation to the baby) to try and induce labour. A few of the midwives I work with have noticed that there seems to be a connection with taking castor oil and having mec liquor, ? it is affecting the baby as well. Thanks in advance Michelle Find local movie times and trailers on Yahoo! Movies.
Re: [ozmidwifery] Castor oil
Hi Michelle, Can't access stuff on my computer to help you as it is dead but there is a research out there somewhere which showed that there is more mec lic in women who have had castor oil than those who did not. Foetal outcomes were as good as the no oil group I think. Can't remember the specific conclucions drawn but not terribly negative. Cheers Judy Michelle Windsor [EMAIL PROTECTED] wrote: Hi, Just wondering if anyone has any info on side effects of women taking castor oil (in relation to the baby) to try and induce labour. A few of the midwives I work with have noticed that there seems to be a connection with taking castor oil and having mec liquor, ? it is affecting the baby as well. Thanks in advance Michelle Find local movie times and trailers on Yahoo! Movies. Find local movie times and trailers on Yahoo! Movies.
Re: [ozmidwifery] Castor oil
Dear Michelle, There is NO evidence that taking castor oil for induction increases the risk ofmec. liq. What is probably more likely is that since the mother is overdue the incidence of mec. liq. increases after 7-10+ days anyway rather than the taking of the castor oil. Mec. liq. is not the end of the world, especially if the mother is overdue and there is no signs of fetal distress. Depending on your workplace the mother needs to negotiatefor intermittent electronic fetal monitoring (if you have to do it at all) and no suction of the baby at birth as the evidence does not support this procedure if done purelyto reduce mec. aspriation. If a baby is going to have mec. aspiration suctioning of the oro-nasal pharynx is not going to help and doesn't reduce the risk. Hope this helps, Anne Clarke Brisbane - Original Message - From: Michelle Windsor To: ozmidwifery@acegraphics.com.au Sent: Tuesday, February 15, 2005 10:33 PM Subject: [ozmidwifery] Castor oil Hi, Just wondering if anyone has any info on side effects of women taking castor oil (in relation to the baby) to try and induce labour. A few of the midwives I work with have noticed that there seems to be a connection with taking castor oil and having mec liquor, ? it is affecting the baby as well. Thanks in advance Michelle Find local movie times and trailers on Yahoo! Movies.
