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. Conclusion 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.