Aim Meconium obstruction(MO) is a clinical entity primarily affecting very-low-birth-weight(VLBW) premature infants. Intestinal obstruction symptoms in a VLBW infant who did not have evidence of necrotizing enterocolitis, did not have another mechanical or functional cause of obstruction defined as MO.
Method We report a series of 14 infants, whose clinical course is indicative of MO of prematurity.
Results One-hundred-thirty VLBW infants born between January 1, 2010 and December 31, 2011. Fourteen(11%) patients were diagnosed as MO. Mean gestational age and birth weight were 28.8±2.6 weeks and 943.7±238.3 g, respectively. Ninety-three percent of infants were delivered by C/S. Eight (57%) of infants had afermentioned prenatal risk factors for MO. The time of the passage of the first meconium was between 10-to-72 hours. All patients presented with distended abdomen and feeding intolerance. Abdominal plain x-rays showed multiple distended intestinal loops without air-fluid levels in all cases. Medical therapy, consisting of rectal enema with saline, if failed, enema with N-acetylcysteine was performed. Eleven of the patients underwent ileostomy surgery between posnatal age of 2-to-43 days. Nine patients (64%) survived, and the times to full enteral feeding was between day of life 13-to-81 days, the median length of hospital stay was 50 days (range 15–92 days) in these patients. One of the patients was diagnosed as Hirschsprung’s disease in the follow-up period.
Conclusion VLBW infants with MO can be diagnosed based on their typical clinical and plain radiographic characteristics. Medical management is effective, whereas some cases may need surgically management as ours.