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Updated: Jun 10, 2026
Protocol and Guidelines for Point-of-Care Lung Ultrasound in Diagnosing Neonatal Pulmonary Diseases Based on International Expert Consensus
Published on: March 6, 2019
[Management of newborns with meconium-stained amniotic fluid: prospective evaluation of practice]
1Unité de réanimation pédiatrique et néonatale, unité de brûlés pédiatriques, département d'anesthésie-réanimation, centre hospitalo-universitaire Nord, Assistance publique-Hôpitaux de Marseille, faculté de médecine de Marseille, université de la Méditerranée, chemin des Bourrelys, 13915 Marseille cedex 20, France. fabrice.michel@ap-hm.fr
Objective:
Regional guideline for immediate tracheal suctioning (ITS) in vigorous and non-vigorous infants born through meconium-stained amniotic fluid (MSAF) has been established in 2003. The objective of this study was to evaluate guideline application.
Study Design:
Prospective cohort.
Patients And Methods:
The first part of the study was a short survey about ITS practices in maternity hospitals then, management and early evolution of babies born through particulate MSAF was evaluated by questionnaire.
Results:
Among 6761 neonates, 199 (3%) were born with MSAF. Early clinical evaluation showed 52 (26%) non-vigorous neonates; 22 of them (42%) have had an ITS. One hundred and forty-seven neonates were vigorous (74%); 27 of them (18%) have had an ITS. Implementation of recommendations in non-vigorous babies was better in maternities of level III, while they were lower in maternities of level IIA for vigorous babies. Among 52 non-vigorous children, eight had a meconium aspiration syndrome (MAS), including five who had an ITS. One MAS occurred in vigorous babies but infection could not be excluded.
Conclusion:
Recommendations for ITS were implemented in 70% of cases but only in 42% of cases in non-vigorous babies. We have to improve formation and circulation of new recommendations.
