Meconium-stained amniotic fluid (MSAF) is noted in ∼13% of deliveries, with some infants developing meconium aspiration syndrome (MAS). Observational studies from the 1970s suggested that intubation and suctioning at delivery could reduce development of MAS and decrease mortality, leading to routine intubation and suctioning for all infants born through MSAF. In the late 1980s, however, deleterious effects were noted with routine suctioning of vigorous neonates.¹ This study was the first large randomized trial assessing whether the tracheal suctioning technique prevented MAS.

To assess whether intubation and suctioning of vigorous, meconium-stained neonates would reduce the incidence of MAS compared to routine delivery room care, and to evaluate the complication rate of this approach.

Prospective randomized controlled trial in 12 centers in the United States, Argentina, and Paraguay from 1995 to 1997.