Effect of Gastric Lavage in Preventing Feeding Problems in Babies Born With Meconium Stained Amniotic Fluid
Effect of Gastric Lavage in Preventing Feeding Problems in Babies Born With Meconium Stained Amniotic Fluid
The purpose of the study is to evaluate the role of gastric lavage in preventing feeding
 problems in babies born through meconium stained amniotic fluid. It is a routine practice in
 many hospitals to perform gastric lavage in all babies born with meconium stained amniotic
 fluid after stabilisation without any supporting evidence. It is believed that meconium is an
 irritant and its presence in stomach causes gastritis and vomiting and hence the basis for
 this practice. Orogastric tube insertion and subsequent gastric lavage is not without
 complications. Potential complications will be prevented and health resources will be saved
 if this procedure is not proven to be beneficial. Therefore the investigators decided to
 study if gastric lavage reduces incidence of vomiting and other feeding difficulties as well
 as incidence of respiratory difficulties in babies born with MSAF.
Meconium passage in newborn infants is a developmentally programmed event normally occurring
 within first 24-48 hours of birth. The meconium staining of amniotic fluid occurs in 12% of
 all live births per annuum.

 The routine use of gastric lavage in MSAF babies has been advocated for a long time as a part
 of the conventional treatment. Meconium in stomach is hypothesized to act as an irritant and
 cause vomiting and retching. Surprisingly this recommendation is also made in some textbooks
 without supporting evidence.

 Orogastric tube insertion and subsequent gastric lavage can cause complications like
 bradycardia, apnea, vomiting, trauma, aspiration and esophageal or gastric perforations. Some
 researchers have found that gastric suction done at birth is associated with long term risk
 for functional intestinal disorder. The sequence of prefeeding behaviour is disrupted in
 children who undergo gastric suction and it can delay initiation of breast feeding. Small
 elevation in mean arterial blood pressure, increased retching have also been reported The
 role of gastric lavage in preventing feeding problems and secondary meconium aspiration
 syndrome has not been systematically evaluated. If this procedure is not proven to be
 beneficial it will prevent potential complications which may arise due to it in a significant
 number of babies. Also in a resource limited country the cost of materials required and time
 of medical personnel will be saved. Hence the purpose of this prospective randomized
 controlled trial is to compare the incidence of feeding problems and secondary meconium
 aspiration syndrome, in gastric lavage group vs no lavage group.
Inclusion Criteria:

 -  Gestation > 34 weeks

 -  Meconium staining of amniotic fluid

 -  Vigorous babies

 Exclusion Criteria:

 -  Major Congenital malformation

 -  Non vigorous babies

 -  Refusal of consent