Suctioning May Not Prevent Meconium Aspiration Syndrome

A multicenter, randomized trial was conducted in 12 centers (11 in Argentina and 1 in the United States) to investigate the effectiveness of intrapartum suctioning in preventing Meconium Aspiration Syndrome (MAS). The 12 centers enrolled 2514 patients born through meconium-stained amniotic fluid (MSAF) of any consistency with gestational age of 37 weeks or more. The infants were randomly allocated to either suctioning of the oropharynx and nasopharynx before delivery of the shoulders (n=1263) or no suctioning (n=1251). Infants randomized to intrapartum suctioning received oropharyngeal suctioning followed by bilateral nasopharyngeal suctioning. No further pharyngeal suctioning was done unless clinically indicated. Once delivered, all infants were treated according to the neonatal resuscitation program guidelines of the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists.¹ The primary outcome was the incidence of MAS, which was defined as respiratory distress in a neonate born through MSAF, need for supplemental oxygen, sustained oxygen requirement, and absence of a major congenital malformation. Major secondary outcome variables included mortality, …