gastric lavage in vigorous neonates born with meconium stained amniotic fluid
TRANSCRIPT
COMMENTARY
Gastric Lavage in Vigorous Neonates Born with MeconiumStained Amniotic Fluid
Rajeev Mehta
Received: 5 December 2012 /Accepted: 5 December 2012 /Published online: 20 December 2012# Dr. K C Chaudhuri Foundation 2012
Meconium stained amniotic fluid (MSAF) is an intra-partumcircumstance that occurs in 10–15 % of term births and requiresmedical attention in infants with signs of respiratory distressrelated to the development of meconium aspiration syndrome[1, 2]. MSAF may have an association with the swallowing ofmeconium prior to delivery, which may cause feeding problemsafter birth [3, 4]. Although gastric lavage may purportedlyremove meconium from the stomach and reduce gastric irrita-tion, previous observational and randomized clinical studieshave not been able to identify a beneficial effect of such aprocedure on the prevention of feeding intolerance in neonatesborn with MSAF [5, 6]. Actually, the harmful effects of gastriclavage (risk for bradycardia, perforation, and aspiration of swal-lowed meconium) may outweigh the expected benefit in vigor-ous infants born through MSAF [4]. The study by Ameta et al.[7] confirms previous observations. Although there appears tobe a reduction in the feeding problems, the difference is notstatistically significant. The American Academy of Pediatricsand International Guidelines for Neonatal Resuscitation thatwere published more than a decade ago, do not recommendgastric suctioning in neonates born with MSAF [8, 9].
References
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R. Mehta (*)Department of Pediatrics,Division of Neonatal-Perinatal Medicine,UMDNJ - Robert Wood Johnson Medical School,New Brunswick, NJ 08901, USAe-mail: [email protected]
Indian J Pediatr (March 2013) 80(3):252DOI 10.1007/s12098-012-0949-8