An important complication in newborn infants born through meconium-stained amniotic fluid (MSAF) is the development of meconium aspiration syndrome (MAS).1 and 2 Limited anecdotal data have led to the widespread practice of intrapartum oropharyngeal and nasopharyngeal suctioning of meconium-stained infants in the presence of MSAF.3 However, other data do not support this approach.4 and 5 Nonetheless, this procedure is practised worldwide for millions of deliveries complicated by MSAF every year.6 and 7
Additionally, prominent organisations such as the International Liaision Committee on Resuscitation, the American Academy of Pediatrics, and the American College of Obstetricians and Gynecologists have recommended the procedure.6, 8 and 9 Although it is no longer advocated in the UK Newborn Life Support Guidelines (Resuscitation Council),10 prenatal suction of meconium-stained infants is still frequently undertaken.
However, no randomised controlled trial so far has specifically assessed the effectiveness of intrapartum oropharyngeal and nasopharyngeal suctioning in the prevention of MAS in deliveries complicated by MSAF. Since intrapartum suctioning has potential risks, the need for assessment of this widely practised procedure should not be ignored.1, 4 and 5
We aimed to assess the effectiveness of intrapartum oropharyngeal and nasopharyngeal suctioning compared with no suctioning in the prevention of MAS and its complications.