Investigation of intrapartum clearence of the upper airway in the presence of meconium contaminated amniotic fluid using an animal model

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Abstract
In order to define as effective a procedure as possible for the intra- and postpartum clearance of the upper airways of meconium contaminated infants, 3 methods of suction clearance, nasal, oral and combined nasal and oral, were carried out on each of 5 kittens aged between 17 to 19 wk. Oral suction immediately after delivery of the infant''s head is much more effective and should be carried out first. When sufficient time is available, nasal suction should be done after completion of pharyngeal clearance. In some instances the amount of meconium can be further reduced. Because a large amount of meconium present in oro- and nasopharynx stays there initially even when spontaneous respiration has begun, a 2nd very careful clearance of the oral and nasal cavities must be carried out postpartum. After the beginning of spontaneous respiration a relatively large proportion of meconium can be found in the stomach. The stomach must always be emptied in order to prevent later regurgitation and aspiration. Because it takes a relatively long time before aspirated material leaves the trachea and the major bronchi into the peripheral airways, repeated endotracheal suction and/or saline lavage can be necessary.

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