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PEDIATRICS Vol. 113 No. 1 January 2004, pp. 133-134

COMMENTARY

Recommendations for Management of the Child Born Through Meconium-Stained Amniotic Fluid

William J. Keenan, MD

Department of Pediatrics and Division of Neonatal-Perinatal Medicine
St Louis University School of Medicine
St Louis, MO 63104

Abbreviations: MSAF, meconium-stained amniotic fluid • NRP, Neonatal Resuscitation Program

The first 20% of the full text of this article appears below.

Approximately 8% to 15% of all infants are born with evidence of meconium-stained amniotic fluid (MSAF).1 Many of these infants rapidly initiate a good respiratory response and are otherwise vigorous. Other infants present with a variety of types of distress from a simple delay in the initiation of respiration to signs of prolonged hypoxemia. The method to best care for these children has been the subject of considerable discussion, especially between obstetricians and pediatricians.

The Neonatal Resuscitation Program (NRP) is a very successful system of instruction taught to >1.5 million providers in >70 countries since its introduction in 1987.2 Although simply an approach to teaching neonatal resuscitation, the recommendations contained in the textbook are widely used in hospitals and often cited in litigation.

Beginning with a 1963 teaching movie by Dr Stanley James at Infants Hospital in New York and stimulated by publications of Gregory et al3 and Ting and Brady,4 . . . [Full Text of this Article]

Address correspondence to William J. Keenan, MD, Departments of Pediatrics and Neonatal-Perinatal Medicine, St Louis University School of Medicine, 1465 S Grand Blvd, St Louis, MO 63104. E-mail: keenanwj@slu.edu


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