In utero meconium suctioning may prevent meconium aspiration

Objective: To assess usefulness of in utero meconium suctioning using endoscopic approach. Materials and Methods: In utero meconium suctioning under direct endoscopic visualization was successfully performed in 11 fetuses in whom thick meconium was detected upon rupture of the membranes. A gas-sterilized flexible fiberoptic scope with an operational channel was introduced via cervix, and meconium was aspirated from the fetal mouth. Definitive suction was performed in all neonates immediately after birth. Results: Endoscopic meconium suctioning was successfully performed in 11 out of 16 fetuses with retrieval of 3-12 ml of meconium. Only 1 neonate in this series of cases had meconium below the vocal cords and none developed meconium aspiration syndrome postnatally. Conclusion: Because fatal meconium aspiration syndrome is largely an intrauterine event, the concept of in utero prophylactic meconium suctioning may serve as an effective modality for its prevention.