Effect of Gastric Lavage on Meconium Aspiration Syndrome and Feed Intolerance in Vigorous Infants Born with Meconium Stained Amniotic Fluid - A Randomized Control Trial.

OBJECTIVE

To compare the incidence of meconium aspiration syndrome and feed intolerance in infants born through meconium stained amniotic fluid with or without gastric lavage performed at birth.

SETTING

Neonatal unit of a teaching hospital in New Delhi, India.

DESIGN

Parallel group unmasked randomized controlled trial.

PARTICIPANTS

700 vigorous infants of gestational age ≥34 weeks from through meconium stained amniotic fluid.

INTERVENTION

Gastric lavage in the labor room with normal saline at 10 mL per kg body weight (n=350) or no gastric lavage (n=350). Meconiumcrit was measured and expressed as ≤30% and >30%.

OUTCOME MEASURES

Meconium aspiration syndrome, feed intolerance and procedure-related complications during 72 h of observation.

RESULTS

5 (1.4%) infants in lavage group and 8 (2.2%) in no lavage group developed meconium aspiration syndrome (RR 0.63, 95% CI 0.21, 1.89). Feed intolerance was observed in 37 (10.5%) and 53 infants (15.1%) in lavage and no lavage groups, respectively (RR 0.70, 95% CI 0.47, 1.03). None of the infants in either group developed apnea, bradycardia or cyanosis during the procedure.

CONCLUSIONS

Gastric lavage performed in the labor room does not seem to reduce either meconium aspiration syndrome or feed intolerance in vigorous infants born through meconium stained amniotic fluid.