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Apgar tests and suctioning questions


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  #1  
May 7th, 2007, 01:27 PM
Ms.Michelle
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I took a waterbirthing course this weekend with all the midwives, doulas and like-minded women on natural childbirth.. I was given lots of information and was wondering your thoughts on how necessary it is to have your baby taken away within the first one minute to 5 minutes for the routine tests of suctioning and Apgar tests? The more information I was given, the more I felt that the Apgar tests aren't really needed and the suctioning was unnecessary, even harmful with the normal development of baby's respiratory and neurological systems. Any thoughts?

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No Benefit Seen With Suctioning During Birth of Meconium-Stained Neonates SAN FRANCISCO (Reuters Health) Feb 11, 2003 - Suctioning during delivery of infants who present with meconium staining apparently does not prevent meconium aspiration syndrome. These findings, presented at the meeting of the Society for Maternal-Fetal Medicine, contradict current practice guidelines.
Lead study author Dr. Edgardo Szyld, of the Hospital Diego Paroissien in Buenos Aires, Argentina, believes that "we should consider revising the current recommendations" of suctioning these infants during delivery.

A total of 2514 infants with meconium-stained amniotic fluid were randomized to oro- and nasopharynx suctioning or to no suctioning just before delivery of the shoulders. Of those infants suctioned, 3.5% developed meconium aspiration syndrome (MAS), as did 3.6% of those not suctioned. Five newborns died in the suctioned group, and three in the group not suctioned.

No differences between the two groups were observed in the frequency of thick meconium, C-sections or need for resuscitation.

A single study back in the 1970s was the foundation for the recommendation of suctioning when meconium staining is evident, Dr. Szyld said. Recommendations to suction, set forth by the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists (ACOG) makes the practice "widespread--and it's done around the world."

However, he said, the current study shows that suctioning before the shoulders are delivered does not prevent meconium aspiration or its complications.

"The data presented by Dr. Szyld's team provides convincing evidence that suctioning probably does not" alter outcomes, Dr. Laura E. Riley, chair of ACOG's Committee on Obstetric Practice, told Reuters Health.

"Because suctioning has been beaten into clinicians for so many years, I'm not sure the current findings are really going to change clinical practice," Dr. Riley said. "Still, I think the findings may provide some reassurance to clinicians that when meconium aspiration syndrome occurs it probably didn't have anything to do with how adequately the infant was suctioned."

While Dr. Riley believes that the researchers succeeded in showing that suctioning is probably unnecessary, she said they didn't address "whether suctioning may actually have harmful effects, such as causing facial trauma."

http://www.gentlebirth.org/archives/meconium.html[/b]
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  #2  
May 7th, 2007, 03:23 PM
jhmomofmany's Avatar Look! A Dancing Banana!
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I think routine suctioning should go the way of holding Baby upside down and giving him/her a swat. I do think it is interesting that they demonstrate it is unnecessary- even hint that it just might be harmful- but still say it probably won't change standard practice.
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  #3  
May 29th, 2007, 12:21 AM
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Oh when, oh when, oh WHEN are they going to finally see the light re: suctioning? There has been study after study after study that show that it DOES NO GOOD (and can do harm in the case of meconium!).

I have a dream that one day obstetrics practices and standards of care will be EVIDENCE BASED. Call me crazy.
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