Endotracheal Suction for Nonvigorous Neonates Born through Meconium Stained Amniotic Fluid: A Randomized Controlled Trial

J Pediatr. 2015 May;166(5):1208-1213.e1. doi: 10.1016/j.jpeds.2014.12.076. Epub 2015 Feb 4.


Objective: To assess whether endotracheal suctioning of nonvigorous infants born through meconium stained amniotic fluid (MSAF) reduces the risk and complications of meconium aspiration syndrome (MAS).

Study design: Term, nonvigorous babies born through MSAF were randomized to endotracheal suction and no-suction groups (n=61 in each). Risk of MAS, complications of MAS and endotracheal suction, mortality, duration of neonatal intensive care unit stay, and neurodevelopmental outcome at 9 months were assessed.

Results: Maternal age, consistency of meconium, mode of delivery, birth weight, sex, and Apgar scores were similar in the groups. In total, 39 (32%) neonates developed MAS and 18 (14.8%) of them died. There were no significant differences in MAS, its severity and complications, mortality, and neurodevelopmental outcome for the 2 groups. One infant had a complication of endotracheal suctioning, which was mild and transient.

Conclusions: The current practice of routine endotracheal suctioning for nonvigorous neonates born through MSAF should be further evaluated.

Trial registration: Clinical Trial Registry of India: CTRI/2013/03/003469.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Amniotic Fluid / chemistry*
  • Apgar Score
  • Birth Weight
  • Delivery, Obstetric
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Intensive Care Units, Neonatal
  • Intensive Care, Neonatal
  • Intubation, Intratracheal
  • Male
  • Meconium
  • Meconium Aspiration Syndrome / prevention & control*
  • Meconium Aspiration Syndrome / therapy
  • Suction / methods*

Associated data

  • CTRI/CTRI/2013/03/003469