Alaaswaify

Dear all, I need your feedback regarding the following question. What's your practice if a woman is colonized with any of the following organism (Klebsiella, pseudomonas, serratia , enterobacter or acinetobacter) whether there is PROM OR NOT ? Do you do sepsis screen and start antibiotics or you just observe the baby or what? Best regards Dr. Alaa Specialist neonatology UAE

Dear dr. Hady, This mail isn't valid , can you send me the correct mail ? Thanks

we use either high peep on conventional ventilator(MAY REACH 8) or HFO . we try to look for the cause; we do PT and PTT, fbc , if PDA is open or if there is Fulminant sepsis . we correct thrombocytopenia by plat. transfusion , prolonged coagulation with FFP, and PRBCS FOR ANEMIA . WE MONITOR CENTRAL BP, SATUARTION AND GAS . ADEQUATE SEDATION OF THE BABY ( MORPHINE OR MIDAZOLAM). IF WE CAN'T MAINTAIN ADEQUATE OXYGENATION , SURFACTANT CAN BE GIVEN + ADEQUATE VENTILATOR MANGEMENT . SOMETIMES WE GIVE DIUREITCS (LASIX) . AVOID TOO MUCH SUCTIONING , FLUID MANAGEMENT ACCORDING TO SUSPECTED CAUSE , CORRECTION OF ACID BASE DISTURBANCES .

Thanks to all of you for the useful feed back. In my openion , as most of you mentioned earlier mec. Aspiration is mainly in utero problem and it's actually an obstetric rather than neonatal emergency. So prevention of aspiration is an obstetric job in first place and neonatologist prevents further complications. I think if there is meconium st. Liquor with maternal risk factors such as evidence of infection, placental insufficiency, IUGR, fetal distress, maternal sedation a neonatologist should attend delivery . If no such risks i guess a person trained in neonatal resuscitation is enough . In my practice all babies so far delivered with mec. St. Liqour and no risk factor were fune at birth. Thanks again for feed back

Dear All, we have great controversies in openion regarding; is that necessary for neonatologist to attend all meconium stained liqour deliveries ? knowing that these deliveries are normal without any evidence of fetal distress, not IUGR, normal CTG and fetal HR . please i need your feedback with evidence if possible . best regards Dr. Alaa specialist neonatology UAE