Publication:

A Randomised controlled equivalency trial on wiping with a cloth (no suction) versus routine suctioning of oronasopharynx at birth, in term neonates born elective Lscs with clear liquor

Background Efficacy of wiping with a cloth compared to suction in routine care is not known. In term elective Lscs with clear liquor, we hypothesise that it has equivalent efficacy with suction.

Methods Randomized controlled equivalency trial with parallel group design. Inclusion criteria was term neonates born elective Lscs, with clear liquor and cried at birth at Government Rajaji Hospital, Madurai. Major congenital anomalies, Depressed or asphyxiated at birth, Meconium staining, Preterm were excluded. The Primary outcome is the time to reach a saturation of 92%. After randomisation, one group received gentle electrical suction and the other wiping of face, mouth and nose using a sterile cloth. The Pulseoximeter readings in the first fifteen minutes of life were transferred to a computer. Other clinical data collected using a Proforma.

Results Among 270 elective Lscs babies, 112 randomized, 58 received suction and 54 wiping. Excluding four babies, 56 Neonates in the suction group and 52 in the no suction group were analysed. The baseline data was similar except for maternal age. The primary outcome, median time to reach 92% saturation is significantly lesser (7 minutes (m)& 6 seconds(s)), [IQR 4m41s, 9m17s] in the no suction group, than the suction group (8 m18 s) [IQR 6m44s, 10m1s] (P value 0.009 ).

Conclusions In term elective LSCS babies with clear liquor and cried at birth, wiping with a sterile cloth has equivalent efficacy compared to suction for routine care.