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

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 nosuction 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.