Recognition, diagnosis and treatment of meconium obstruction in extremely low birth weight infants.
BACKGROUND
Meconium obstruction (MO) of prematurity can result in increased morbidity or mortality and prolonged hospitalization if not diagnosed and treated appropriately.


OBJECTIVE
The aims of our study were to identify the incidence and risk factors associated with MO and to review the treatment outcomes.


METHODS
A retrospective analysis was undertaken of 101 extremely low birth weight infants (ELBWIs) who were born between January 1, 2007, and April 1, 2009, at Seoul National University Hospital. Prenatal and neonatal factors were compared between the MO and control groups. The treatment outcomes were also reviewed.


RESULTS
Twenty-two (22%) patients were diagnosed as having MO. Eighteen of these patients (82%) had prenatal risk factors for MO. Respiratory distress syndrome was more prevalent in the MO group than in the control group (p = 0.001). Overall, 17 of the 22 patients (77%) were relieved with medical treatment and the rest underwent ileostomy. The times to full enteral feeding did not differ between the medically treated group and the control group. However, the surgically treated group required more time to achieve full enteral feeding, and some patients had persistent gastrointestinal problems.


CONCLUSIONS
MO is not a rare condition in ELBWIs, and the majority of ELBWIs have prenatal risk factors. Medical management was effective, and medically manageable cases had good prognoses for subsequent feeding, whereas some surgically managed cases had persistent gastrointestinal problems.
Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea.
Yoon-Joo
YJ
Kim
Ee-Kyung
EK
Kim
Eun Sun
ES
Kim
Han-Suk
HS
Kim
Jung-Hwan
JH
Choi
Jung-Eun
JE
Cheon
Woo Sun
WS
Kim
In-One
IO
Kim
Kwi Won
KW
Park
D000328:Adult; D015897:Comorbidity; D004374:Ductus Arteriosus, Patent / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D005260:Female; D005865:Gestational Age; D006801:Humans; D007081:Ileostomy; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007415:Intestinal Obstruction / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D008297:Male; D008470:Meconium; D010927:Placental Insufficiency / Q000453:epidemiology / Q000473:pathology; D011247:Pregnancy; D056910:Republic of Korea / Q000453:epidemiology; D012127:Respiratory Distress Syndrome, Newborn / Q000453:epidemiology / Q000473:pathology*; D012189:Retrospective Studies; D012744:Sex Ratio; D016216:Ultrasonography, Prenatal