Skip to main content
Log in

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

  • Research Paper
  • Published:
Indian Pediatrics Aims and scope Submit manuscript

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.

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Bhat R, Rao A. Meconium-stained amniotic fluid and meconium aspiration syndrome: a prospective study. Ann Trop Paediatr. 2008;28:199–203.

    Article  PubMed  CAS  Google Scholar 

  2. Narang A, Nari PMC, Bhakoo ON. Management of meconium stained amniotic fluid: A team approach. Indian Pediatr. 1989;30:9–13.

    Google Scholar 

  3. Trimmer KJ, Gilstrap LC 3rd. “Meconiumcrit” and birth asphyxia. Am J Obstet Gynecol. 1991;165:1010–3.

    Article  PubMed  CAS  Google Scholar 

  4. Rossi EM, Philipson EH, Williams TG, Kalhan SC. Meconium aspiration syndrome: intrapartum and neonatal attributes. Am J Obstet Gynecol. 1989; 161:1106–10.

    Article  PubMed  CAS  Google Scholar 

  5. Sharma P, Nangia S, Tiwari S, Goel A, Singla B, Saili A. Gastric lavage for prevention of feeding problems in neonates with meconium stained amniotic fluid: A randomized controlled trial. Peditar Int Child Health. 2014;34:115–9.

    Article  Google Scholar 

  6. Narachi H, Kulayat N. Is gastric lavage needed in neonates with meconium-stained amniotic fluid? Eur J Pediatr. 1999;158:315–7.

    Article  Google Scholar 

  7. Ameta G, Upadhyay A, Gothwal S. Role of gastric lavage in vigorous neonates born with meconium stained amniotic fluid. Indian J Pediatr. 2013;80:195–8.

    Article  PubMed  Google Scholar 

  8. Anand KJS, Runeson B, Jacobson B. Gastric suction at birth associated with long term risk for functional intestinal disorders in later life. J Pediatr. 2004;144:449–54.

    Article  PubMed  CAS  Google Scholar 

  9. Stoll B. The Newborn Infant. In: Kliegman R, Jenson H, Behrman R, Stanton B. editors, Nelson’s Textbook of Pediatrics (18thed). Saunders Elsevier Publications India. 2008. p. 675–83.

    Google Scholar 

  10. Bahl D. A Study of Neonatal Outcome in Relation to Meconiumcrit of Liquor Amnii. MD Thesis, University of Delhi, 1993.

    Google Scholar 

  11. Ballard JL, Khoury JC, Wedig K, Wang L, Eilers-Walsman BL, Lipp R. New Ballard Score, expanded to include extremely premature infants. J Pediatr. 1991; 119:417–23.

    Article  PubMed  CAS  Google Scholar 

  12. Bhat S. Respiratory distress in newborns In: Achar’s textbook of Pediatrics, 4th ed. Universities Press; 2009. p.221.

    Google Scholar 

  13. Wiswell TE, Bent RC. Meconium staining and the meconium aspiration syndrome: Unresolved issues. Pediatr Clin N Am. 1993;50:955–81.

    Article  Google Scholar 

  14. JeevaSankar M, Agarwal R, Mishra S, Deorari AK, Paul VK. Feeding of low birth weight infants. Neonatology protocols. Indian J Pediatr. 2008;75:459–69.

    Google Scholar 

  15. Shah L, Shah GS, Singh RR, Pokharel H, Mishra OP. Status of gastric lavage in neonates born with meconium stained amniotic fluid: A randomized controlled trial. Italian J Pediatr. 2015;41:85.

    Article  CAS  Google Scholar 

  16. Garg J, Masand R, Tomar BS. Utility of gastric lavage in vigorous neonates delivered with meconium stained liquor: A randomized controlled trial. Int J Pediatr. 2014;2014:204807.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Cuello-García C, González-López V, Soto-González A. Gastric lavage in healthy term newborns: A randomized controlled trial. Ann Pediatr (Barc). 2005;63:509–13.

    Article  Google Scholar 

  18. Deshmukh M, Balasubramanian H, Rao S, Patole S. Effect of gastric lavage on feeding in neonates born through meconium-stained liquor: A systematic review. Arch Dis Child Fetal Neonatal Ed. 2015;100:F394–9.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M. M. A. Faridi.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gidaganti, S., Faridi, M.M.A., Narang, M. et al. Effect of Gastric Lavage on Meconium Aspiration Syndrome and Feed Intolerance in Vigorous Infants Born with Meconium Stained Amniotic Fluid — A Randomized Control Trial. Indian Pediatr 55, 206–210 (2018). https://doi.org/10.1007/s13312-018-1318-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13312-018-1318-0

Keywords

Navigation