Oronasopharyngeal suction versus no suction in normal and term infants delivered by elective cesarean section: a prospective randomized controlled trial

Gynecol Obstet Invest. 2006;61(1):9-14. doi: 10.1159/000087604. Epub 2005 Aug 19.


Background/aim: There are controversies about the routine use of oronasopharyngeal suction (ONPS) in healthy infants. This study aimed to compare the effects of oronasopharyngeal suction with those of no suction in normal, term infants delivered by cesarean section.

Methods: 140 term, healthy newborns of uncomplicated pregnancies were prospectively randomized to one of two groups according to the use of ONPS procedure. Differences in oxygen saturation levels, heart rates, and Apgar scores were determined.

Results: The mean SaO(2) values through the 2nd and 6th min of life were significantly higher in the no suction group (p < 0.001). The maximum time to reach SaO(2) of > or =92% (6 vs. 11 min) and > or =86% (5 vs. 8 min) saturation were shorter in the no suction group than in the ONPS group. The mean heart rates were consistently and significantly lower in the no suction group during the first 6 min except the second one. All neonates without suction had an Apgar score of 10 at the 5th min, while the mean +/- SD for ONPS group was 9.34 +/- 0.48 (p < 0.001).

Conclusion: Although findings remained on statistical level and did not lead to clinically adverse outcomes, there is no statistical or physiological basis for oronasopharyngeal suction as a systematic procedure in healthy, term infants delivered by cesarean section.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Apgar Score
  • Birth Weight
  • Carbon Dioxide / blood
  • Cesarean Section*
  • Female
  • Fetal Blood
  • Heart Rate
  • Humans
  • Hydrogen-Ion Concentration
  • Infant, Newborn / blood
  • Infant, Newborn / physiology*
  • Oxygen / blood*
  • Pharynx
  • Prospective Studies
  • Suction*


  • Carbon Dioxide
  • Oxygen