This prospective study is to verify if airway MSAF suction by obstetrician(OB) at birth modifies the clinical course and the radiological findings in the newborn infant (NB). 88 newborn infants with MSAF (51 thick meconium) were submitted to tracheal suction through an endotracheal tube by the pediatrician at delivery room (DR). They were divided in two groups according to airway suction of MSAF by the OB soon after head delivery:

  • Group A - suctioned by OB: n=53, BW=3.3 ± 0.8kg, GA=40 ± 2wk, 21% vaginal delivery,

  • Group B - not suctioned by OB: n=35, BW=3.1 ± 0.7kg, GA=40 ± 2wk, 46% vaginal delivery

t test: group A = B for BW and GA; chi square: group A < B for delivery, p=0.01.

Groups were compared regarding bag ventilation in DR (bag), presence of meconium in the trachea (mec). Apgar score at 1′ and 5′ (A1′ and A5′), presence of respiratory distress for more then 4h (RD), use of mechanical ventilation (Vent) and length of stay in the hospital (LOS). All patients had a Chest X Ray (CXR) between 6-24h of life. CXR were evaluated by a radiologist unaware of the clinical status of the patients, and classified as normal or altered (Alt).

The table shows the following results: Apgar at 1′ and 5′, Mann Whitney - A > B, p ≤ 0.04; presence of mechanical ventilation, Fisher A = B, p = 0.057; presence of abnormal CXR - chi square A < B, p=0.05. One patient of group B died at 45 days with hypoxic-ischemic encephalopathy. The main CXR abnormalities in both groups were hyperinflation, atelectasis and air leaks.

Table 1
Full size table

Airway suction of MSAF by OB at delivery room decreases Chest X Ray abnormalities and may reduce the need of mechanical ventilation in the newborn infants. More emphasis should be given to airway suction of MSAF by OB, specially in vaginal deliveries.