Shrishail Gidaganti1, M M Faridi2, Manish Narang1, Prerna Batra1. 1. From Division of Neonatology, Department of Pediatrics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India. 2. From Division of Neonatology, Department of Pediatrics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India. Correspondence to: Dr MMA Faridi, Flat # G-4, Plot # 14, Block-B, Vivek Vihar Delhi 110 095, India. drmmafaridi@gmail.com.
Abstract
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.
RCT Entities:
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.