In 1903, Whitridge Williams declared “A characteristic sign of impending asphyxia is the escape of meconium”. It’s unlikely this statement was founded on robust, peer-reviewed research, though there has since been research a-plenty based on the underlying inference that in-utero meconium passage is associated with poorer outcomes. Had researchers instead begun with questioning if meconium is indeed an independent marker for those poorer outcomes, then we may nowadays have a better understanding of why most infants with a poor outcome do not pass meconium in labour (Greenwood et al 2003) and most babies exposed to meconium liquor are born in good condition.
Using the findings from an extensive review of the literature, this presentation will begin by exploring the theories of meconium passage. It will review the research that is currently shaping our meconium guidelines (meconium as pathological) and analyse the data that supports the concept of meconium passage as a physiological, i.e., ‘normal’, event. Then, using the evidence, it will critique the current assessment and management practices of meconium labours and infants born through meconium.
Does meconium deserve its reputation as an omen for poor outcomes? Or have we been unjustly scared meconiumless??
Learning Objectives:
1) Describe the evidence which supports the concept of meconium as pathological
2) Explain the concept of meconium passage as a normal, physiological event
3) Describe assessment and management practices of labours with meconium liquor in relation to the evidence
4) Describe assessment and management practices of infants born through meconium liquor in relation to the evidence /P
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