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

ABSTRACT

Objective: To compare the incidence of meconium aspirationsyndrome and feed intolerance in infants born through meconiumstained amniotic fluid with or without gastric lavage performed atbirth.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 weeksfrom through meconium stained amniotic fluid.Intervention Gastric lavage in the labor room with normal salineat 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, feedintolerance and procedure-related complications during 72 h ofobservation.Results: 5 (1.4%) infants in lavage group and 8 (2.2%) in nolavage group developed meconium aspiration syndrome (RR0.63, 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 ineither group developed apnea, bradycardia or cyanosis during theprocedure.Conclusion: Gastric lavage performed in the labor room does notseem to reduce either meconium aspiration syndrome or feedintolerance in vigorous infants born through meconium stainedamniotic fluid.Keywords Neonate, Prevention, Respiratory distress, Riskfactors, Vomiting.