Deviation in the Standard of Obstetrical Care Resulting in Meconium Aspiration

Evaluate breaches in the standard of care when analyzing whether or not there has been a Deviation in the Standard of Obstetrical Care Resulting in Meconium Aspiration

Answer the following questions to find out if the standard of care was followed for your case.

  • Was meconium detected in the amniotic fluid?
    Yes
    No
    Why is this important?
    The appearance of meconium in the amniotic fluid before or during labor is often a source of anxiety for clinicians. It has the potential to cause direct harm to both the newborn child and the mother.
    (2007) 34 ECLPER 4 653-665

  • Was continuous electronic fetal monitoring performed to assess fetal well-being? Why is this important?
    Answer this question
    
The finding of meconium should prompt a thorough evaluation of the mother and baby, including continuous fetal heart rate monitoring. Abnormal fetal heart rate patterns are the best predictors of those who will require intervention at birth. Many cases of meconium aspiration syndrome can be prevented by assessment of risk factors, continuous fetal monitoring and removal of meconium from the airways.

    (2007) 34 ECLPER 4 653-665 



  • Were the fetal heart rate tracings within normal limits? Why is this important?
    Answer this question
    
Patients with abnormal fetal heart rate patterns have a significantly higher likelihood of requiring emergent labor management.

    (2007) 21 EBPCOG 4 609-624 



  • Was the mother diagnosed with chorioamnionitis (intra-amniotic infection)? Why is this important?
    Answer this question
    
There is a link between meconium stained amniotic fluid and the development of chorioamnionitis.

    (2010) 31 EPLACN 2 113-120 



  • Did the clinician administer antibiotics to the patient? Why is this important?
    Answer this question
    
Meconium stained amniotic fluid is associated with increased rates of both chorioamnionitis and endomyometritis. Intravenous antibiotic prophylaxis in patients with meconium stained amniotic fluid is necessary to avoid infection development.

    (2004) 31 ECLPER 4 765-782 



  • Was an emergency delivery performed? Why is this important?
    Answer this question
    
Anytime the clinician suspects fetal distress, surgical delivery needs to be considered.

    (2007) 8 EAICMD 8 331-336 



  • Was a neonatologist or a pediatrician present for the delivery? Why is this important?
    Answer this question
    
In an obstetrical emergency, consultation with either a pediatrician or a neonatologist is necessary for the safety and care of the baby.

    (2007) 34 ECLPER 4 653-665 



  • Which of the following signs of distress did the newborn exhibit? (Choose all that apply) Why is this important?
    Answer this question
    
If the infant is not vigorous, has absent or depressed respirations, has decreased muscle tone, or has a heart rate less than 100 beats/min, immediate emergency treatment is required such as intubating and suctioning the trachea (post-partum suctioning).

    (2007)34 ECLPER 4 653-665 



  • What was the baby’s APGAR SCORE at one minute? Why is this important?
    Answer this question
    
The initial neonatal assessment formalized in the Apgar score is used to identify the infant who may need resuscitation or who may need additional intervention.

    (1999) 26 EOGCNA 4 711-723 



  • Was intubation and endotracheal suctioning of the newborn performed immediately after delivery? Why is this important?
    Answer this question
    
When an Apgar score is low, the airway needs to be cleared as quickly as possible and to minimize the amount of meconium aspiration.

    (2007) 34 ECLPER 4 653-665 



  • Was an umbilical cord blood (arterial) gas obtained? Why is this important?
    Answer this question
    
Umbilical cord blood samples obtained at the time of delivery are useful to document fetal acid-base status.

    (2009) 23 EBPCOG 3 357-368