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Childbirth

Share experiences and get support around labour, birth and recovery.

Might be an odd question, but does anyone understand the grading system for meconium?

2 replies

jofeb04 · 26/01/2008 23:31

Just re-reading my hospital notes, and noticed that they say the merconium was a Grade 3. Haven't seen it being used before, and just wondering how the grading works, and how serious it is etc.

Thanks

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Mintpurple · 27/01/2008 08:49

Hi jofeb04 - it used to be light, medium and thick mec, now grades 1,2 and 3.

Grade 1 or light (very thin mec, almost like consomme soup) is not enough to really worry about, probably not have a paed at delivery etc, If initial CTG trace had been ok, probably ok with intermittent monitoring.

Grade 2 (like very watered down pea soup)will be enough for continuous monitoring, have a paed at delivery, therefore cord clamped and cut, over to resusc trolley for at least a look at the vocal cords to check for mec.

Grade 3 (glutinous pea soup)is really treated just like 2 but thicker mec.

Meconium is not necessarily a sign of distress, although it can be (usually in the presence of other factors like CTG decelerations), as it is very common in post dates babies due to maturity making the bowels start to work, more common in African women, possibly a sign of previous stress in old mec etc

It is of no real consequence in breech births, as most babies will poo as they descend through the pelvis.

The big worry is of course mec aspiration, which although rare, can be very serious, causing aspiration pneumonia or it can be fatal, but like I said, thankfully very rare.

Unfortunately, in most hospitals, it is enough to get a transfer from BC to L/W, no waterbirth, continuous monitoring etc, so it can ruin an otherwise really lovely birth.

Postnatally, baby will probably be on observations for 24 - 48 hours, so no early discharge.

This is common to most hospitals I have worked in, some may differ a bit but basically the above will apply in most cases. Sorry about being a bit graphic

Lecture over, hope this helps.

jofeb04 · 27/01/2008 13:08

Hi Mintpurple,
Thanks for the information. I've never seen a grading before (orpossibly never read my previous notes that good!).

My mw and consultant was concerned about the mec aspiration, as the fetal blood sample came back showed my dd was severely distressed. Also had to stay in hospital for 24hours as well.

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