Abstract
Objective. To determine the incidence of feed intolerance in vigorous babies with meconium stained liquor (MSL) who received prophylactic gastric lavage as compared to those who were not subjected to this procedure. Design. Randomized controlled trial. Setting. Tertiary care teaching hospital. Participants/Intervention. 330 vigorous babies delivered with MSL and satisfying the predefined inclusion criteria were randomized either to receive gastric lavage (group A, n = 165) or to not receive gastric lavage (group B, n = 153). Clinical monitoring was subsequently performed and recorded in prestructured proforma. Results. There was no significant statistical difference (P > 0.05) in incidence of feed intolerance in “lavage” and “no lavage” groups. Secondary Outcome. There was no evidence of secondary respiratory distress in either group. None of the patients in the lavage group exhibited adverse effects owing to the procedure. Conclusions. There is no role of prophylactic gastric lavage in neonates born with MSL.
Highlights
Meconium is a blackish-green sticky material composed of debris of intestinal cells, lanugo hair, vernix, liquor, and bile pigments [1, 2]
It is thought that the presence of meconium in the stomach can act as a chemical irritant and can cause feeding problems [8]
Gastric lavage has been routinely employed with this belief to evacuate the gastric contents and avoid feeding problems but like other procedures it has been associated with complications [8, 11, 12]
Summary
Meconium is a blackish-green sticky material composed of debris of intestinal cells, lanugo hair, vernix, liquor, and bile pigments [1, 2]. The incidence of meconium stained liquor (MSL) varies between 7% and 22% of life births [3,4,5,6,7]. It is thought that the presence of meconium in the stomach can act as a chemical irritant and can cause feeding problems [8]. These are 2.8 times more frequent in neonates born with MSL than those born without it, regardless of consistency of the amniotic fluid [9]. It has been hypothesized that some cases of meconium aspiration syndrome might be caused by postnatal aspiration of gastric contents into the airways [10]. Gastric lavage has been routinely employed with this belief to evacuate the gastric contents and avoid feeding problems but like other procedures it has been associated with complications [8, 11, 12]
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