Role of gastric lavage in newborn with meconium stained amniotic fluid:A randomized controlled trail

Kumar, Akhilesh; gupta, Ramjee prasad; Singh, Alka

doi:10.9790/0853-1603045153

Cited by 3 publications

(15 citation statements)

References 9 publications

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“…The primary aims of the included studies related to GI symptoms. Most studies used GI outcomes including vomiting, retching, or regurgitation as the main outcomes [ 1 , 2 , 5 , 7 , 10 , 11 , 13 – 15 , 17 ]. The terms related to GI symptoms including vomiting, retching, and regurgitation were used in all previous studies [ 1 , 2 , 5 , 7 , 10 – 17 ], but were defined using different terminology.…”

Section: Resultsmentioning

confidence: 99%

“…The terms related to GI symptoms including vomiting, retching, and regurgitation were used in all previous studies [ 1 , 2 , 5 , 7 , 10 – 17 ], but were defined using different terminology. Some studies also employed the terms feeding intolerance, feeding problem, and feeding difficulty [ 10 , 12 , 15 , 16 ] with GI symptoms as part of the definition. Increased abdominal girth or feeding residual were also symptoms of feeding intolerance [ 10 , 12 , 15 , 16 ].…”

Section: Resultsmentioning

confidence: 99%

“…Some studies also employed the terms feeding intolerance, feeding problem, and feeding difficulty [ 10 , 12 , 15 , 16 ] with GI symptoms as part of the definition. Increased abdominal girth or feeding residual were also symptoms of feeding intolerance [ 10 , 12 , 15 , 16 ]. Most of the included RCTs had some risk of bias, and one trial showed a high risk of bias ( S1 Fig ).…”

Section: Resultsmentioning

confidence: 99%

“…Vomiting was defined as any episode of expulsion of gastric contents with effort occurring sometime after feeding, and which contained altered milk, meconium, or bile [ 13 , 15 ]. Regurgitation was defined as effortless expulsion of milk during or immediately after feeding [ 13 , 15 ]. Retching was defined as attempted vomiting without expulsion of any gastric contents [ 13 ].…”

Section: Methodsmentioning

confidence: 99%

“…Currently, three randomized controlled trials (RCTs) have evaluated the benefits of routine gastric suction in healthy neonates [1,2,5] and nine RCTs have investigated the use of gastric lavage in vigorous infants with MSAF [7,[10][11][12][13][14][15][16][17], while a previous meta-analysis focused on gastric lavage in MSAF [18,19]. We therefore conducted a systematic review and meta-analysis to evaluate the benefits and harms of performing routine gastric suctioning or gastric lavage in vigorous neonates.…”

Section: Introductionmentioning

confidence: 99%

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Benefits and harms of gastric suction or lavage at birth for gastrointestinal outcomes: A systematic review and meta-analysis

2023

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The benefits of routine gastric suctioning or lavage in neonates remain uncertain, despite the common practice worldwide. To investigate the potential advantages and harms, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) examining the effects of these procedures in healthy or meconium-stained neonates at birth. We systematically searched PubMed, Scopus, Embase, Ovid, and the Cochrane Library databases from inception to February 9, 2023. We included only RCTs assessing the outcomes of gastric suction or lavage in neonates at birth. We calculated risk ratio (RR) and weighted mean differences with 95% confidence intervals (CIs) using a random-effects model. The primary outcomes were gastrointestinal symptoms including vomiting, retching, feeding intolerance, and secondary aspiration. The secondary outcomes included time to initiation of breastfeeding and potential adverse procedure-related events. Twelve RCTs with a total of 4,122 neonates were analyzed. All the studies compared neonates who received gastric suction or lavage with those who received usual care. Gastrointestinal symptoms were significantly reduced in neonates receiving gastric suction or gastric lavage compared with the control group (RR, 0.75; 95% CI, 0.63–0.89). Gastric lavage was beneficial for infants with meconium-stained amniotic fluid (RR 0.71; 95% CI, 0.60–0.84), while gastric suction had no significant benefit in reducing gastrointestinal symptoms in infants without meconium-stained amniotic fluid (RR 0.91; 95% CI, 0.61–1.37). Our findings suggest that gastric suction or lavage may reduce gastrointestinal symptoms in neonates; however, these procedures may only benefit infants born with meconium-stained amniotic fluid. Vigorous newborns without meconium-stained amniotic fluid may not benefit from these procedures. Furthermore, gastric suction may lead to adverse outcomes such as apnea and bradycardia. Registration: This study was registered in the PROSPERO International prospective register of systematic reviews in health and social care (CRD42023247780).

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Benefits and harms of gastric suction or lavage at birth for gastrointestinal outcomes: A systematic review and meta-analysis

2023

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Gastric Lavage for Prevention of Feeding Intolerance in Neonates Delivered Through Meconium-Stained Amniotic Fluid: A Systematic Review and Meta-Analysis

2021

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Gastric lavage to reduce feed intolerance among vigorous neonates >34 weeks born through meconium stained liquor: A comparative study

Manoj Kumar Gupta,

Dhirendra Prasad Yadav,

Mohammad Ashfaque Ansari

et al. 2023

Asian J Med Sci

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Background: Feed intolerance during early postnatal period is common in newborns with meconium-stained liquor (MSL). Prophylactic gastric lavage in neonates delivered with MSL and its recommendation by some pediatric textbooks, despite negligible scientific evidence and evidence-based recommendations. Aims and Objectives: This study was designed with the objective of determining if gastric lavage in all babies with MSL led to the development of less feed intolerance as compared to those who were not subject to the procedure. Materials and Methods: The present study was a randomized control trial, conducted at National Medical College and Teaching Hospital, Birgunj, from December 01, 2021, to November 30, 2022. The study populations were 280 vigorous neonates with ≥34 weeks of gestation and ≥1800 g delivered with MSL. Among them, 140 neonates were kept in the lavage and non-lavage group. Data were analyzed using the Chi-square test, odds ratio, and level of significance at P<0.05. Results: Thirty-two (22.85%) and 54 (38.57%) neonate in the lavage and no lavage group developed the first episode of vomiting with a significant P=0.005. No significant difference in the incidence of feed intolerance was found (8.57% vs. 15%, P=0.099). None of the neonates in either group developed any complications during the procedure. Conclusion: Gastric lavage seems to reduce the first episode of vomiting but not overall feed intolerance in vigorous infants born through meconium-stained amniotic fluid. Hence, concluded that gastric lavage should be reserved for treating the rather rare feed intolerance than routine prophylactic in vigorous neonates delivered with MSL.

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Role of gastric lavage in newborn with meconium stained amniotic fluid:A randomized controlled trail

Cited by 3 publications

References 9 publications

Benefits and harms of gastric suction or lavage at birth for gastrointestinal outcomes: A systematic review and meta-analysis

Benefits and harms of gastric suction or lavage at birth for gastrointestinal outcomes: A systematic review and meta-analysis

Gastric Lavage for Prevention of Feeding Intolerance in Neonates Delivered Through Meconium-Stained Amniotic Fluid: A Systematic Review and Meta-Analysis

Gastric lavage to reduce feed intolerance among vigorous neonates >34 weeks born through meconium stained liquor: A comparative study

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