Meconium-stained amniotic fluid occurs after 38 weeks of gestation when the fetus passes meconium into the amniotic fluid due to hypoxia. Hypoxia stimulates the vagal nerve, which causes relaxation of the anal sphincter and peristalsis of the fetal gastrointestinal tract. Meconium-stained amniotic fluid can range in color from black to greenish-yellow or brown and may be thin or thick in consistency. Nursing care involves documenting the fluid, notifying the neonatal resuscitation team, gathering equipment, and following the suction protocol to suction the mouth, nose, or below the vocal cords depending on the neonate's respiratory and muscle tone status and heart

1. Meconium-stained Amniotic Fluid
after 38 weeks of gestation due to fetal maturity of normal physiological
functions
fetus has had an episode of loss of sphincter control, allowing meconium to pass
into amniotic fluid
Umbilical cord compression results in fetal hypoxia that stimulates the vagal
nerve in mature fetuses
Hypoxia stimulates the vagal nerve, which induces peristalsis of the fetal
gastrointestinal tract and
relaxation of the anal sphincter
Amniotic fluid – black to greenish, yellow, or brown.
Consistency may be thin or heavy
Criteria for evaluation
breech presentation
Present with no changes in FHR
Stained fluid accompanied by variable or late decelerations in FHR
(ominous sign)
Nursing Care
Document color and consistency of stained amniotic fluid.
Notify neonatal resuscitation team to be present at birth.
Gather equipment needed for neonatal resuscitation.
Follow designated suction protocol.
¦¦ Assess neonate–s respiratory efforts, muscle tone, and heart rate.
¦¦ Suction mouth and nose using bulb syringe if respiratory efforts strong,
muscle tone good, and
heart rate greater than 100/min.
¦¦ Suction below the vocal cords using an endotracheal tube before spontaneous
breaths occur if
respirations are depressed, muscle tone decreased, and heart rate less than
100/min.