The Medical College of Wisconsin to Launch PEARL Trial

The PEARL Trial is a randomized clinical study led by Brock E. Polnaszek, MD, MPH, assistant professor of obstetrics and gynecology (maternal fetal medicine), designed to determine whether a standardized, protocol-driven approach to warm amnioinfusion during labor can improve both short- and long-term pediatric health outcomes in the highest-risk infants exposed to thick meconium-stained amniotic fluid. The three-year, $350,000 Gerber Foundation Research Award will support this work, which seeks to answer a long-standing question in obstetrics: whether standardized warm amnioinfusion during labor can protect newborns from neurologic and respiratory complications, both immediately and later in life, following exposure to meconium.

Meconium affects roughly one in seven pregnancies and is associated with conditions such as NICU admission, persistent pulmonary hypertension, and long-term developmental delays. The PEARL Trial will enroll 320 maternal-infant dyads at ≥36 weeks’ gestation and is among the first studies to use an objective, point-of-care measure of meconium thickness (“meconium-crit”), incorporate fidelity checklists to ensure consistent delivery of warm amnioinfusion, and evaluate both inflammatory biomarkers at birth and developmental outcomes at one year of age.

By addressing key limitations of previous research, the PEARL Trial aims to generate clear, evidence-based guidance for managing meconium during labor and ultimately improve both short- and long-term pediatric outcomes.