A term newborn delivered through meconium-stained amniotic fluid is vigorous with normal respiratory effort and heart rate above 100/min. According to current neonatal resuscitation guidelines, what is the correct initial management?
- A Routine endotracheal intubation and tracheal suction
- B Routine oropharyngeal suction before delivery of shoulders
- C Standard care with drying, warming and observation ✓
- D Gastric lavage via nasogastric tube
Correct answer: C. Standard care with drying, warming and observation
Explanation
Current NRP and IAP guidelines recommend against routine suctioning for meconium-stained amniotic fluid, whether intrapartum or postnatal. A vigorous infant should be managed with standard steps: warmth, drying, stimulation and observation. Routine intubation and tracheal suctioning showed no benefit in randomized trials and was abandoned after 2015.
Reference: Textbook of Neonatal Resuscitation (AAP/AHA), 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.