Need for endotracheal intubation and suction in meconium-stained neonates

J Pediatr. 1988 Apr;112(4):613-5. doi: 10.1016/s0022-3476(88)80183-5.


In a prospective study, we determined whether routine immediate tracheal aspiration at birth is necessary in meconium-stained but otherwise normal infants delivered vaginally and having a 1-minute Apgar score greater than 8. A total of 572 newborn infants who met these criteria were randomly allocated to one of two groups. All infants underwent oropharyngeal suctioning with a DeLee catheter while the head was still on the perineum. In group I (n = 308) suctioning of the trachea under direct vision was performed instantly at birth; in group II (n = 264) this procedure was not done. There was no mortality among infants in the study, but morbidity, mainly pulmonary and laryngeal disorders, occurred in six of 308 group I infants and in none of the group II infants (P less than 0.025). Immediate tracheal suction is not a harmless intervention, and should be considered superfluous in a vigorous term neonate born with meconium-stained amniotic fluid.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Apgar Score
  • Humans
  • Infant, Newborn
  • Intubation, Intratracheal / adverse effects*
  • Meconium Aspiration Syndrome / therapy*
  • Prospective Studies
  • Random Allocation
  • Respiration Disorders / etiology*
  • Respiratory Sounds / etiology
  • Suction