Delivery room management of meconium staining of the amniotic fluid and the development of meconium aspiration syndrome.

A 1-year prospective survey of obstetric and pediatric management of meconium staining of the amniotic fluid in 464 patients was undertaken. Pharyngeal suctioning before delivery was performed using bulb syringe (N = 130), De Lee suction catheter (N = 186), or both (N = 98); endotracheal intubation after delivery was also done in 413 instances. Using any of the three suctioning techniques, no differences were seen in Apgar scores, respiratory rates, presence or absence of meconium on or below the vocal cords, or development of meconium aspiration syndrome (MAS). If meconium was present on the vocal cords, it was present below the vocal cords in 76% of the cases. If no meconium was visualized, it was found below the vocal cords in only 7% of the cases. Of the 142 infants with meconium below the vocal cords, 10% developed MAS and all 14 survived.