"Pulling the plug" - Management of meconium plug syndrome in neonates

Alex G. Cuenca, Anam S. Ali, David W. Kays, Saleem Islam

Research output: Contribution to journalArticle

Abstract

Background: The significance of meconium plug syndrome (MPS) is unclear but has been associated with Hirschsprung's disease and magnesium tocolysis. We reviewed our experience to attempt to identify any potential association with these conditions and to review our outcomes. Methods: Using the International Classification of Diseases, Ninth revision, code for meconium obstruction, patient charts were identified during the 1998-2008 period. A total of 61 cases of MPS were found, after excluding 7 of meconium ileus. Data regarding the hospital course and outcomes were collected and analyzed. Results: Approximately 30% of patients had spontaneous resolution of the meconium plug without any treatment. Of those patients requiring treatment, contrast barium enema was used, with 97% success. Only 2 patients required surgical intervention owing to worsening distension and subsequent peritonitis. When we stratified the patients according to gestational age of >36 and <36 wk, contrast barium enemas were performed 2.2 ± 1.8 versus 8.6 ± 7.8 d after birth (P = 0.003), respectively, and the lower gestational age patients had a longer length of stay. Contrast barium enema was still successful in 94% of patients with a gestational age of <36 wk. Magnesium tocolysis was noted in 16% of the cases, and Hirschsprung's disease was only found in 3.2% of patients. Conclusions: Patients with MPS have excellent outcomes, independent of gestational age. Contrast barium enema remains the initial diagnostic and treatment of choice for patients with MPS. Also, although previous reports have shown a link between magnesium tocolysis and Hirschsprung's disease with MPS, our experience suggests otherwise.

Original languageEnglish (US)
JournalJournal of Surgical Research
Volume175
Issue number2
DOIs
StatePublished - Jun 15 2012
Externally publishedYes

Fingerprint

Meconium
Newborn Infant
Tocolysis
Hirschsprung Disease
Gestational Age
Magnesium
Ileus
International Classification of Diseases
Peritonitis
Length of Stay
Therapeutics
Parturition

Keywords

  • Hirchsprung's disease
  • Left colon syndrome
  • Meconium ileus
  • Meconium plug syndrome

ASJC Scopus subject areas

  • Surgery

Cite this

"Pulling the plug" - Management of meconium plug syndrome in neonates. / Cuenca, Alex G.; Ali, Anam S.; Kays, David W.; Islam, Saleem.

In: Journal of Surgical Research, Vol. 175, No. 2, 15.06.2012.

Research output: Contribution to journalArticle

Cuenca, Alex G. ; Ali, Anam S. ; Kays, David W. ; Islam, Saleem. / "Pulling the plug" - Management of meconium plug syndrome in neonates. In: Journal of Surgical Research. 2012 ; Vol. 175, No. 2.
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