morphine and Infant--Newborn--Diseases

Neonates born through meconium-stained amniotic fluid (MSAF) may develop complications including meconium aspiration syndrome, persistent pulmonary hypertension of newborn and death. The approach to the resuscitation of these neonates has significantly evolved for the past few decades. Initially, under direct visualization technique, neonates with MSAF were commonly suctioned below the vocal cords soon after delivery. Since 2015, Neonatal Resuscitation Program (NRP. 出生于羊水胎粪污染的新生儿可发生新生儿胎粪吸入综合征、持续性肺动脉高压等并发症，甚至死亡。在过去的几十年里，羊水胎粪污染新生儿复苏已发生了几次重要的变革。最初，对于羊水胎粪污染新生儿，通常在其出生后立即采用喉镜直视下吸引声门下胎粪。自2015年起，美国儿科学会新生儿复苏指南不再推荐对羊水胎粪污染无活力新生儿“常规”给予气管插管吸引胎粪，但建议立即给予气囊面罩正压通气复苏。然而，最新版2021年中国新生儿复苏指南仍保留对无活力新生儿进行胎粪吸引的建议。该文旨在探讨过去60年中美两国新生儿复苏指南在羊水胎粪污染新生儿复苏方法中的差异及其原因。.

Topics: Amniotic Fluid; Child; China; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intubation, Intratracheal; Meconium; Meconium Aspiration Syndrome; Resuscitation

Meconium peritonitis (MP) is a sterile, chemical peritonitis resulting from in-utero fetal bowel perforation. Severe cases may lead to serious morbidities and mortalities.. To review the common antenatal ultrasound abnormalities associated with MP, and identify radiological and clinical prognostic factors.. Retrospective review of all neonates with MP from January 1997 to December 2019 treated in our hospital was performed. Antenatal ultrasound findings, clinical presentations and outcomes were analyzed.. Thirty-five neonates (17 males, 18 females) were included in the study. Thirty-two (91.4%) attended antenatal screening, and 27 (84.4%) of them had abnormalities identified on antenatal ultrasound. The most common abnormality was polyhydramnios (43.8%). Nineteen (54.3%) patients were inborn. Twenty (57.1%) patients were born prematurely. Laparotomy was required in 85.7% of patients. The median time to laparotomy was shorter in the inborn group [1 day (0-9 days) vs 4 days (2-34 days), p = 0.001], but the duration of post-operative hospital stay was comparable [71 days (16-423 days) vs 73.5 days (23-231 days)]. However, such duration was found to be significantly longer in the pre-term group when compared to full-term [58.5 days (16-89 days) vs 85 (21-423 days), p = 0.01]. The most common pathology was small bowel atresia and there were two mortalities.. Due to the advancement in prenatal detection, pediatric anesthesia, intensive care and surgical techniques, the morbidity and mortality of MP has much decreased. Effective multi-disciplinary antenatal counseling facilitated the perinatal management of MP and resulted in comparable prognosis and outcome in inborn and outborn neonates.

Topics: Child; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Perforation; Male; Meconium; Peritonitis; Pregnancy; Tertiary Care Centers; Ultrasonography, Prenatal

The use of licit and illicit drugs and exposure to other xenobiotic agents during pregnancy is common. These substances are known to have adverse effects on the pregnancy and fetus; however information on fetal exposure is sparse due to the lack of an appropriate measure of exposure. Meconium analysis is a new method for identifying in utero exposure of infants to a number of illicit and legal drugs, alcohol, nicotine, heavy metals, pesticides, congenital infections. It's testing is non-invasive, highly accurate and able to detect prior exposure in utero during 12-40 weeks of gestation. This has implications for toxicology to develop improved methods to identify exposed infants.

Topics: Designer Drugs; Female; Health Education; Humans; Illicit Drugs; Infant, Newborn; Infant, Newborn, Diseases; Maternal Welfare; Meconium; Mothers; Pregnancy; Prenatal Exposure Delayed Effects; Risk Factors; Substance-Related Disorders; Xenobiotics

Meconium staining of the amniotic fluid in labor is a frequent problem that is associated with an increase in the risk of neonatal and maternal morbidity. Amnioinfusion is a simple technique that is designed to prevent neonatal and maternal morbidity associated with meconium. Preliminary studies indicate that amnioinfusion is a promising approach to the prevention of such complications of labor. However, further research is required. The primary objective of this multi-centre randomized controlled study is to determine if amnioinfusion for thick meconium stained amniotic fluid results in a reduction in perinatal death or moderate to severe meconium aspiration syndrome. We will also assess the effects of amnioinfusion on other indicators of neonatal morbidity and on cesarean section. The study includes an evaluation of womens views on their childbirth experience and an economic evaluation of a policy of amnioinfusion The study will be achieved with the collaboration of approximately 50 obstetrical centres from across Canada, US, Europe, South America and South Africa. This multicentre trial will provide urgently needed information on the efficacy and effectiveness of amniofusion for the indication of meconium stained amniotic fluid.

Topics: Amniotic Fluid; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Meconium Aspiration Syndrome; Multicenter Studies as Topic; Patient Selection; Randomized Controlled Trials as Topic

Imaging plays a major role in most neonatal gastrointestinal emergencies. The role may vary from helping to establish a diagnosis, to the evaluation of associated abnormalities, to surgical planning, or to therapy for some conditions like meconium ileus or meconium plug syndrome. Plain radiographs and ultrasound serve a primary imaging modalities with bowel contrast examinations, CT scan, and MR imaging playing roles in more complex cases.

Topics: Abdomen, Acute; Diagnostic Imaging; Digestive System Abnormalities; Digestive System Surgical Procedures; Emergencies; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

In the Federal Republic of Germany screening for cystic fibrosis by the albumin content of meconium (BM-test) is performed on most newborns. In this paper arguments for and against this test are discussed. Arguments in favour of BM-test-screening are the possibility of early diagnosis, early treatment and genetic counseling. Drawbacks of the test are false positive and false negative results. The authors conclude that this screening test should not be performed.

Topics: Cystic Fibrosis; False Negative Reactions; False Positive Reactions; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Reagent Strips; Serum Albumin

Topics: Acid-Base Equilibrium; Apgar Score; Asphyxia Neonatorum; Atropine; Bicarbonates; Blood Transfusion; Calcium Gluconate; Epinephrine; Female; Fetal Blood; Fetal Organ Maturity; Glucose; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intubation, Intratracheal; Isoproterenol; Lung; Meconium; Narcotic Antagonists; Pregnancy; Resuscitation; Sodium Bicarbonate

Topics: Asphyxia Neonatorum; Blood Viscosity; Female; Fetal Growth Retardation; Humans; Hyperglycemia; Hypocalcemia; Hypoglycemia; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Patient Care Team; Pneumonia, Aspiration; Pregnancy; Prognosis

Topics: Cystic Fibrosis; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Mass Screening; Meconium

Topics: Female; Fetus; Humans; Infant, Newborn; Infant, Newborn, Diseases; Inhalation; Meconium; Pregnancy; Respiration; Respiratory Tract Diseases

Topics: Abdomen, Acute; Abdominal Muscles; Angiography; Biliary Tract; Bladder Exstrophy; Enterocolitis, Pseudomembranous; Gastroesophageal Reflux; Gastrointestinal Diseases; Hernia, Diaphragmatic; Hernia, Umbilical; Humans; Infant Nutritional Physiological Phenomena; Infant, Newborn; Infant, Newborn, Diseases; Intensive Care Units; Intestinal Atresia; Intestinal Obstruction; Meconium; Monitoring, Physiologic; Radionuclide Imaging; Ultrasonography

Topics: Child, Preschool; Colonic Diseases; Cystic Fibrosis; Female; Humans; Ileum; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Obstruction; Intestine, Small; Jejunum; Meconium; Methods

Topics: Adult; Amniotic Fluid; Autopsy; Cesarean Section; Female; Fetal Death; Hematoma; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Maternal Age; Meconium; Middle Aged; Obstetric Labor Complications; Obstetrical Forceps; Pregnancy; Umbilical Cord; Umbilical Veins

Topics: Birth Weight; Contrast Media; Enterocolitis, Pseudomembranous; Female; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Intestinal Mucosa; Intestinal Perforation; Intestines; Male; Meconium; Necrosis; Pneumatosis Cystoides Intestinalis; Pneumoperitoneum; Radiography

Topics: Birth Weight; Diagnosis, Differential; Humans; Infant Food; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Megacolon; Therapeutic Irrigation

Topics: Animals; Bilirubin; Enzyme Induction; Exchange Transfusion, Whole Blood; Food; Growth Disorders; Humans; Hyperbilirubinemia; Infant, Newborn; Infant, Newborn, Diseases; Light; Lighting; Liver; Liver Circulation; Meconium; Phenobarbital; Photolysis; Phototherapy; Rats; Retina; Sunlight; Time Factors

Topics: Anal Canal; Congenital Abnormalities; Cystic Fibrosis; Duodenal Obstruction; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Obstruction; Meconium; Megacolon; Pancreas; Rectum

Our objective was to study the strength of the association between meconium-stained amniotic fluid and severe morbidity among neonates of nulliparas with prolonged pregnancies.. This was a secondary analysis of the NOCETER randomized trial that took place between 2009 and 2012 in which 11 French maternity units included 1373 nulliparas at 41. This study included 1274 patients: 803 (63%) in the group with normal amniotic fluid, 196 (15.4%) in the thin amniotic fluid group, and 275 (21.6%) in the thick amniotic fluid group. The neonates of patients with thick amniotic fluid had higher rates of neonatal morbidity than those of patients with normal amniotic fluid (7.3% vs. 2.2%; p < 0.001; adjusted relative risk [aRR] 3.3, 95% confidence interval [CI] 1.7-6.3), but those of patients with thin amniotic fluid did not (3.1% vs. 2.2%; p = 0.50; aRR 1.0, 95% CI, 0.4-2.7).. Among nulliparas at 41

Topics: Amniotic Fluid; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Meconium Aspiration Syndrome; Obstetric Labor Complications; Pregnancy; Pregnancy Complications; Pregnancy, Prolonged

To study the nature and clinical outcome of pregnancies with obstetric cholestasis on active management and to correlate perinatal outcome to gestational age at delivery.. This prospective randomized study included 69 women with obstetric cholestasis. Fetal surveillance began at 34 weeks or later at diagnosis and included daily maternal record of fetal movements, and biophysical profile (i.e. non stress test, the four quadrant amniotic fluid index). Fetal monitoring was conducted weekly before 36 weeks and biweekly after that. Randomization into two groups was done where one group was planned for delivery at 37 weeks whereas in the other group, pregnancy was carried to 38 weeks under surveillance. The primary outcome variable was correlation of fetal and neonatal complication rates to gestational age at delivery.. There were no stillbirths in the study. No episode of fetal asphyxia or bradycardia was observed. The overall rate of meconium passage was 7.46% (5/67). However, there was no case of meconium aspiration syndrome. Women delivering at or after 38 weeks had a lower incidence of cesarean section (17.85% vs 25.8%), neonatal nursery admission (17.85% vs 22.5%), and neonatal jaundice (17.85% vs 19.35%) compared to those delivering at 37 weeks. The differences between the two groups were, however, not found to be statistically significant.. The current study demonstrates that with active intervention, pregnancies with obstetric cholestasis can be carried to a later gestation under surveillance.

Topics: Adult; Cesarean Section; Cholestasis, Intrahepatic; Female; Humans; India; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Obstetric Labor Complications; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Risk

To determine whether intrapartum amnioinfusion (AI) relieves recurrent moderate and severe variable decelerations in laboring women with clear or grade I meconium-stained amniotic fluid and reduces cesarean section rate for fetal distress.. A randomized controlled trial was conducted in labor unit of Christian Medical College Hospital, Vellore, India, between October 2003 and September 2004. Women were randomized to receive AI (group I) and not to receive it (group II).. A total of 150 women (75 in each group) were included in the study. There was significant relief of variable decelerations in group I and no difference in overall cesarean section rate but significant reduction in cesarean section rate for fetal distress in group I, and significant reduction in cesarean section rate for fetal distress in nulliparous women of group I. Neonatal acidemia was also significantly reduced in the nulliparous women receiving AI. The duration of maternal postpartum hospital stay was significantly reduced in group I. There were no adverse maternal or neonatal outcomes.. AI was a beneficial therapeutic intervention in women patients showing fetal distress in first stage of labor, and it reduced cesarean section for fetal distress and neonatal acidemia.

Topics: Amniotic Fluid; Cesarean Section; Female; Fetal Distress; Fetal Membranes, Premature Rupture; Heart Rate, Fetal; Humans; Infant, Newborn; Infant, Newborn, Diseases; Labor, Obstetric; Length of Stay; Meconium; Oligohydramnios; Parity; Peroxisomal Disorders; Postpartum Period; Pregnancy; Recurrence

To determine the usefulness of amnioinfusion as a function of meconium concentration and amniotic fluid index.. This was a prospective study of 206 pregnant women in whom amniotic fluid was moderately or heavily stained with meconium, according to subjective evaluation. The women were assigned randomly to receive amnioinfusion (n=103) or no amnioinfusion (control group, n=103). The results were compared in women with =/<15 % or >15 % meconium in the amniotic fluid (measured by centrifugation), and in women in whom the amniotic fluid index calculated 60 min after insertion of the amnioinfusion catheter was <10 or =/>10.. In women with >15% meconium, amnioinfusion decreased the rate of cesarian sections motivated by fetal distress (2.5% vs 22.2%), and in women with =/<15% meconium, amnioinfusion decreased the presence of meconium below the vocal cords (6.4% vs 25.9%). Greater benefits after amnioinfusion were seen in women with an amniotic fluid index =/>10: the rate of cesarian sections was lower (1.3% vs 13.3%), as was the frequency of meconium below the vocal cords (10.1% vs 33.3%).. Beneficial effects of amnioinfusion were seen in women with high and low concentrations of meconium, and with high and low amniotic fluid indexes. These criteria should therefore not be used to decide whether amnioinfusion is indicated when the amniotic fluid is moderately or heavily stained with meconium.

Topics: Adult; Amniotic Fluid; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infusions, Parenteral; Meconium; Pregnancy; Prospective Studies

Meconium staining of the amniotic fluid in labor is a frequent problem that is associated with an increase in the risk of neonatal and maternal morbidity. Amnioinfusion is a simple technique that is designed to prevent neonatal and maternal morbidity associated with meconium. Preliminary studies indicate that amnioinfusion is a promising approach to the prevention of such complications of labor. However, further research is required. The primary objective of this multi-centre randomized controlled study is to determine if amnioinfusion for thick meconium stained amniotic fluid results in a reduction in perinatal death or moderate to severe meconium aspiration syndrome. We will also assess the effects of amnioinfusion on other indicators of neonatal morbidity and on cesarean section. The study includes an evaluation of womens views on their childbirth experience and an economic evaluation of a policy of amnioinfusion The study will be achieved with the collaboration of approximately 50 obstetrical centres from across Canada, US, Europe, South America and South Africa. This multicentre trial will provide urgently needed information on the efficacy and effectiveness of amniofusion for the indication of meconium stained amniotic fluid.

Topics: Amniotic Fluid; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Meconium Aspiration Syndrome; Multicenter Studies as Topic; Patient Selection; Randomized Controlled Trials as Topic

Topics: Amniotic Fluid; Female; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Meconium Aspiration Syndrome

We present a case of an infant born to a mother with COVID-19, who at 24 hours of life was treated with a glycerin suppository for failure to pass meconium and went on to develop bilious emesis and abdominal distention as feeding continued over the next several hours. After a barium enema identified the distal obstruction, the pediatric surgical team used rectal irrigation to remove a large meconium plug, which mimicked the appearance of the descending colon on plain film, in a case of small left colon syndrome. Although intestinal obstruction in the newborn is rare, it is imperative that it is promptly diagnosed and treated appropriately to avoid negative outcomes; which, even in perhaps the mildest form of functional distal obstruction, meconium plug syndrome, can lead to an impressive clinical illness with risk of intestinal perforation and subsequent meconium peritonitis if the obstruction is not relieved.

Topics: Child; COVID-19; Cystic Fibrosis; Female; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Vomiting

Topics: Amniotic Fluid; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Miliaria; Pregnancy Complications

A shift in the Neonatal Resuscitation Program (NRP) guidelines occurred in 2015 from routine intubation and endotracheal suctioning of all meconium-stained non-vigorous infants towards less aggressive interventions based on response to initial resuscitation. This study aims to examine the impact of this change on outcomes of non-vigorous infants born through meconium-stained amniotic fluid at a level III academic NICU encompassing years before and after the change in guideline. This single-center retrospective study compared NICU therapies and clinical outcomes of 117 non-vigorous newborns pre-guideline implementation to 106 non-vigorous newborns post-guideline implementation. Nearly two thirds of infants in the pre-guideline cohort received endotracheal suctioning with recovery of meconium compared to less than a third of infants in the post-guideline cohort (p<0.01). Though a higher proportion of the pre-guideline cohort were admitted to the NICU for respiratory issues compared to the post-guideline cohort, the two groups did not differ significantly with regard to morbidity and therapies. Despite a marked reduction in rates of intubation and endotracheal suctioning, there is no difference in outcomes between pre-guideline implementation vs post-guideline implementation in non-vigorous meconium-stained infants, supporting the recent NRP guideline change and highlighting the benefit of expectant management.

Topics: Amniotic Fluid; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intubation, Intratracheal; Meconium; Meconium Aspiration Syndrome; Resuscitation; Retrospective Studies

The passage of meconium during labor increased the chance of undesirable birth outcomes. The adverse effects of meconium are worsening in resource-limited countries. In Ethiopia, there is an argument concerning meconium's negative effects and management on pregnant women and their babies. Therefore, this study was intended to assess the adverse maternal and perinatal outcomes of meconium in term labor in the South Gondar Zone, Ethiopia.. A prospective cohort study was conducted using 580 laboring mothers (145 exposed and 435 nonexposed groups). A two-stage sampling method was implemented to get study subjects. The data were collected using an interviewer-administered structured questionnaire and a medical chart review. SPSS version 25 was used for data analysis. Chi-squared and Fisher's exact tests were used to compare the two groups' differences. The strength of the association was measured using relative risk with a 95% CI.. There was more operative delivery (28.3% versus 5.3%), puerperal sepsis (79.54% versus 2.06%), nonreassuring fetal heart rate pattern (29.7% versus 2.1%), meconium aspiration syndrome (7.58% versus 0.68%), neonatal sepsis (9% versus 4.1%), perinatal asphyxia (13.8% versus 7.6%), admission to the neonatal intensive care unit (23.4% versus 3.2%), and early neonatal deaths (4.8% versus 1.4%) among meconium stained groups as compared to the clear amniotic fluid groups.. Meconium-stained amniotic fluid significantly increased adverse maternal and perinatal outcomes in Ethiopia. The risk of perinatal asphyxia, nonreassuring fetal heart rate pattern, neonatal sepsis, meconium aspiration syndrome, admission to the NICU, early neonatal death, operative delivery, and puerperal sepsis were significantly higher in meconium-exposed groups. Special attention should be given to meconium-exposed mothers during the intrapartum period and in postnatal follow-up.

Topics: Amniotic Fluid; Asphyxia; Asphyxia Neonatorum; Ethiopia; Female; Hospitals; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Meconium Aspiration Syndrome; Neonatal Sepsis; Pregnancy; Pregnancy Complications; Prospective Studies

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Amniotic Fluid; Female; Gastric Lavage; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Parturition; Pregnancy

To evaluate the short-term outcomes of non-vigorous infants born through meconium-stained amniotic fluid (MSAF) before and after implementation of no-tracheal suctioning guidelines.. Single-center retrospective study of ≥36-week gestation neonates with MSAF.. During routine-suction era (9/2013-12/2014), 280/2306 neonates (12%) were born through MSAF and 39 (14%) were non-vigorous. Thirty (77%) of non-vigorous infants underwent tracheal suctioning. In the no-suction era (1/2017-12/2018), 282/2918 neonates (9.7%) were born through MSAF and 30 (10.6%) were non-vigorous and one needed intubation. Admissions for meconium aspiration syndrome (15% vs 53%) and respiratory distress (18% vs 57%) were significantly higher among non-vigorous infants in the no-suction era.. In this single-center study, non-vigorous infants born through MSAF without routine-tracheal suctioning had a higher incidence of NICU admission for MAS and respiratory distress compared to the routine-suction era. Multicenter randomized trials evaluating tracheal suction in non-vigorous infants with MSAF are warranted.

Topics: Amniotic Fluid; Female; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Meconium Aspiration Syndrome; Respiratory Distress Syndrome; Retrospective Studies; Suction

Meconium aspiration syndrome (MAS) in neonates born through meconium-stained amniotic fluid (MSAF) causes significant morbidity and mortality. Early recognition of at-risk neonates could help optimize treatment. The aim was to determine predictive characteristics of cord blood pH, base deficit and lactate with subsequent MAS. Receiver operating characteristic (ROC) curves with area under curve (AUC) were estimated. Among 231 MSAF complicated pregnancies, 25 (10.8%) had MAS. Mean cord pH was significantly lower in neonates with MAS compared to those without MAS (7.15 ± 0.11 vs. 7.26 ± 0.07; p < 0.001). Median lactate between the two groups [5.6 (7.5, 3.7) vs. 2.7 (4.5, 2.0)] and base deficit [-10.6 (-13.2, -4.2) vs. -3.7 (-6.3, -2.6)] also differed significantly (p = 0.01). ROC curve area for cord lactate, pH, and base deficit were 0.81, 0.79, and 0.75, respectively. The predictive cutoff values for pH, lactate, and base deficit were 7.20, 3.55 mmol/L, and -5.3 mmol/L, respectively.

Topics: Amniotic Fluid; Female; Fetal Blood; Humans; Infant, Newborn; Infant, Newborn, Diseases; Lactic Acid; Meconium; Meconium Aspiration Syndrome; Pregnancy

Topics: Amniotic Fluid; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Pregnancy Complications

Transition of clear amniotic fluid to meconium-stained fluid is a relatively common occurrence during labor. However, data regarding the clinical significance and the prognostic value of the presence of meconium-stained amnionic fluid (MSAF) are scarce. This study aimed to investigate delivery and neonatal outcomes according to the presence of MSAF and the timing of the meconium passage.. We used an historical cohort study at a single tertiary medical center in Israel between the years 2011 and 2018. Women were divided into two groups according to timing of meconium passage: primary MSAF (MSAF present at membrane rupture) and secondary MSAF (clear amnionic fluid that transitioned to MSAF during labor). Neonatal complication rates were compared between groups. Composite adverse neonatal outcome was defined as arterial cord blood pH <7.1, 5 min Apgar score ≤7, and/or neonatal intensive care unit admission.. The study cohort included 56 863 singleton term births. Of these, 9043 (15.9%) were to women who had primary MSAF, and 1484 (2.6%) to those with secondary MSAF. Secondary MSAF compared with primary MSAF increased the risks of cesarean birth and operative vaginal delivery, increased the risks of low one- and five-minute Apgar scores and low arterial cord blood pH, and increased hospital stay duration. Multivariate analysis revealed that secondary MSAF was independently associated with an increased risk of composite adverse neonatal outcome (OR1.68, 95% CI 1.25-2.24, p < 0.001) compared with primary MSAF.. In this sample, secondary MSAF was associated with more adverse neonatal outcomes than primary MSAF. Closer monitoring of fetal well-being may be prudent in these cases.

Topics: Amniotic Fluid; Apgar Score; Cohort Studies; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Pregnancy; Pregnancy Complications

To assess the correlation between total area under the Curve (AUC) of decelerations and accelerations and neonatal acidemia in pregnancies complicated with meconium-stained amniotic fluid (MSAF).. A retrospective cohort study was conducted among women who delivered with a diagnosis of MSAF. Electronic fetal monitoring (EFM) patterns 120 min before delivery were interpreted by a researcher blinded to fetal outcomes. The primary outcome was fetal acidemia, defined as umbilical artery pH below 7.10. The correlation was tested using the Spearman correlation coefficient.. A total of 102 women were included; 24 delivered infants with cord blood pH < 7.20, and only five delivered infants with cord blood pH < 7.10. A significant correlation was demonstrated between total AUC of decelerations and accelerations and cord blood pH (P = 0.02). A sub-analysis according to gestational age at delivery (up to and beyond 40 weeks) was conducted. A significant correlation was demonstrated (P = 0.02) only in the term group(n = 37).. A correlation was demonstrated between total AUC of decelerations and accelerations and cord blood pH in neonates with MSAF. This correlation was significant for neonates delivered before 40 weeks of gestation, but not for those delivered after 40 weeks of gestation.

Topics: Acidosis; Amniotic Fluid; Deceleration; Female; Fetal Blood; Humans; Hydrogen-Ion Concentration; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Pregnancy; Pregnancy Complications; Retrospective Studies

Meconium-stained amniotic fluid is considered as the bad predictor of fetal outcome having significant perinatal morbidity and mortality. This study aimed to compare immediate fetal outcomes in meconium-stained amniotic fluid and clear amniotic fluid.. Hospital-based comparative observational study was conducted from a total of 204 women admitted in labour room at a tertiary level hospital. Among them, 102 were cases with meconium-stained amniotic fluid, and 102 were comparison groups with clear amniotic fluid. Fetal outcome was compared between these two groups.. The study findings revealed that majority (74.5%) in the study group had cesarean section as compared to 14.7% in the comparative group. More than one-fourth (26.5%) of the newborns in the study group had moderate to severe birth asphyxia, needed resuscitation (25.5%) and neonatal intensive care unit admission (25.5%) as compared to 3.9% from the comparative group. Maternal age (COR=0.34, 95%CI=0.15-0.81), color of amniotic fluid (COR=0.11; 95%CI=0.04-0.33), meconium consistency (COR=0.27; 95%CI=0.17-0.43), and mode of delivery (COR=0.36; 95%CI=0.17-0.79) were associated with birth asphyxia in bivariate analysis. Maternal age (AOR=2.66; 95%CI=1.04-6.81) and color of amniotic fluid (AOR=11.50; 95%CI=2.97-44.56) were associated with birth asphyxia in the multivariate analysis.. Meconium-stained amniotic fluid was associated with increased frequency of cesarean section and adverse fetal outcome with birth asphyxia being the major complications compared with clear amniotic fluid. Predictors of birth asphyxia were maternal age and color of amniotic fluid.

Topics: Amniotic Fluid; Asphyxia; Asphyxia Neonatorum; Cesarean Section; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Nepal; Pregnancy; Pregnancy Complications

Delivery room management of infants delivered through meconium stained amniotic fluid has evolved over the past four decades. The burden of disease weighs more heavily in low- and middle-resource areas. Current information does not allow for precise prediction of infants that will require resuscitation at delivery versus those that need simple stabilization. Optimal care of newborns requires assessment of risk factors and obstetrical and pediatric team preparation to respond to the needs of the newborn.

Topics: Amniotic Fluid; Child; Female; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Meconium Aspiration Syndrome; Suction

We aimed to evaluate the association between meconium-stained amniotic fluid during labor and offspring's childhood wheezing. This study analyzed the data of participants enrolled in the Japan Environment and Children's Study, a nationwide prospective birth cohort study, between 2011 and 2014. Data of women with singleton live births between 22 and 40 weeks' gestation were analyzed. Participants were categorized into two groups according to the presence or absence of meconium-stained amniotic fluid. The primary outcome measure was the offspring's childhood wheezing up to 3 years of age. A logistic regression model was used to calculate the adjusted odds ratio for childhood wheezing in children of women with meconium-stained amniotic fluid, considering those without meconium-stained amniotic fluid as a reference, taking into account the potential confounding factors affecting the incidence of wheezing. We analyzed data from 61,991 participants: 1796 (2.9%) participants had meconium-stained amniotic fluid during labor and 18,919 (30.5%) of the offspring had childhood wheezing. The adjusted odds ratios for the offspring's childhood wheezing were 0.89 (95% confidence interval, 0.79-0.99) in total participants, 0.87 (95% confidence interval, 0.78-0.97) in term births, and 2.00 (95% confidence interval, 0.98-4.09) in preterm births.. This study revealed a decreased incidence of childhood wheezing among the children of women with meconium-stained amniotic fluid in term births. By yet unknown mechanisms, meconium-stained amniotic fluid was associated with a decreased incidence of childhood wheezing in the offspring. Further studies are required to clarify the mechanism of one's own meconium in affecting their health condition.. • Meconium-stained amniotic fluid during labor is associated with several adverse perinatal outcomes, and meconium aspiration syndrome is associated with offspring's childhood asthma and wheezing. • Meconium-stained amniotic fluid during labor could be an independent protective factor for the offspring's dermatitis and skin rash.. • Whole cases with meconium-stained amniotic fluid during labor were associated with a decreased incidence of offspring's childhood wheezing up to 3 years of age. • This study may shed light on the effects of simple meconium-stained amniotic fluid on offspring's childhood health.

Topics: Amniotic Fluid; Child; Cohort Studies; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Japan; Meconium; Meconium Aspiration Syndrome; Pregnancy; Pregnancy Complications; Prospective Studies; Protective Factors; Respiratory Sounds

Clinical data with respect to the impact of meconium on the prognosis of neonatal bacterial meningitis are scarce. Therefore, in this study, we aimed to determine whether meconium-stained amniotic fluid (MSAF) represents a risk factor for poor prognosis of neonatal bacterial meningitis in a confirmed case population.. This was a retrospective cohort study of 256 neonates diagnosed with bacterial meningitis hospitalized at one of three hospitals in Shantou, China, between October 2013 and September 2018. Clinical manifestation, laboratory test results and treatment were compared between the two groups, with outcomes dichotomized into 'good' or 'poor' prognosis. Multivariate analysis and follow-up logistic regression analysis were used to identify predictive factors of a poor outcome.. Of the 256 neonates with BM, 95 (37.1%) had a good prognosis at discharge and 161 (62.9%) had a poor prognosis. In the poor prognosis group, 131/161 (79.4%) neonates had a permanent neurological sequelae and 19 (11.8%) had ≥2 sequelae. Of note, 11 neonates died. The rate of poor prognosis of BM was significantly higher among neonates with than without MSAF (26.1% vs. 12.6%, respectively; p < 0.05). A logistic multivariate analysis to evaluate the prognostic effect of MSAF to BM showed that neonatal with MSAF is more likely to have a worse prognosis of BM [unadjusted odds ratio (OR), 2.44, 95% confidence interval (CI), 1.24-5.10; adjusted OR, 2.31; 95% CI, 1.09-5.17].. MSAF is significantly associated with poor prognosis of neonatal bacterial meningitis. Therefore, in case of MSAF, more attention should be paid to neonatal bacterial meningitis.

Topics: Amniotic Fluid; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Meningitis, Bacterial; Pregnancy Complications; Retrospective Studies

Several common maternal or neonatal risk factors have been linked to meconium amniotic fluid (MAF) development; however, the results are contradictory, depending on the study. This study aimed to assess the prevalence and risk factors of MAF in singleton pregnancies.. This study is a retrospective cohort that assessed singleton pregnant mothers who gave birth at a tertiary hospital in Bandar Abbas, Iran, between January 1st, 2020, and January 1st, 2022. Mothers were divided into two groups: 1) those diagnosed with meconium amniotic fluid (MAF) and 2) those diagnosed with clear amniotic fluid. Mothers with bloody amniotic fluid were excluded. Demographic factors, obstetrical factors, and maternal comorbidities were extracted from the electronic data of each mother. The Chi-square test was used to compare differences between the groups for categorical variables. Logistic regression models were used to assess meconium amniotic fluid risk factors.. Of 8888 singleton deliveries during the study period, 1085 (12.2%) were MAF. MAF was more common in adolescents, mothers with postterm pregnancy, and primiparous mothers, and it was less common in mothers with GDM and overt diabetes. The odds of having MAF in adolescents were three times higher than those in mothers 20-34 years old (aOR: 3.07, 95% CI: 1.87-4.98). Likewise, there were significantly increased odds of MAF in mothers with late-term pregnancy (aOR: 5.12, 95% CI: 2.76-8.94), and mothers with post-term pregnancy (aOR: 7.09, 95% CI: 3.92-9.80). Primiparous women were also more likely than multiparous mothers to have MAF (aOR: 3.41, 95% CI: 2.11-4.99).. Adolescents, primiparous mothers, and mothers with post-term pregnancies had a higher risk of MAF. Maternal comorbidities resulting in early termination of pregnancy can reduce the incidence of MAF.

Topics: Adolescent; Adult; Amniotic Fluid; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Pregnancy; Pregnancy Complications; Pregnancy, Prolonged; Retrospective Studies; Risk Factors; Tertiary Care Centers; Young Adult

To evaluate the impact of prolonged exposure to meconium-stained amniotic fluid (MSAF), in women with term pre-labor spontaneous rupture of membranes (PROM), on pregnancy outcome.. A retrospective cohort study of women who gave birth in a single university-affiliated tertiary medical center (2011-2019). Eligibility was limited to singleton pregnancies at term who presented with PROM. Women with MSAF were immediately induced and were compared to low-risk pregnant women with clear amniotic fluid (CAF) at admission who underwent induction of labor 24 h after rupture of membranes. All women were stratified into 4-time frame groups from rupture of membranes to delivery: T0: 0-7 h, T1: 8-13 h, T2: 14-18 h, and T3: > 18 h for the MSAF group. The time frames for the CAF were: T0 - 24-31 h, T1: 32-38 h, T2: 40-44 h, and T3: > 44 h. The maternal adverse composite outcome included any of the following: intrapartum fever (IPF), prolonged second stage (PSS), need for manual removal of suspected retained placenta, postpartum hemorrhage, and readmission within 45 days after delivery. The adverse composite neonatal outcome included one or more of the following: meconium aspiration syndrome, neonatal asphyxia, need for respiratory support, and intracranial hemorrhage.. Prolonged rupture of membranes in the presence of meconium does not affect maternal outcomes, however, prolonged exposure to meconium lead to an increased adverse neonatal outcome.

Topics: Amniotic Fluid; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Meconium Aspiration Syndrome; Placenta, Retained; Postpartum Hemorrhage; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Premature Birth; Retrospective Studies; Rupture, Spontaneous

We aimed to compare obstetric and neonatal outcomes of deliveries complicated by meconium stained amniotic fluid (MSAF), according to placental histology of continuous vs. acute meconium associated changes.. This was a retrospective cohort study of singleton deliveries complicated by MSAF at a single university-affiliated medical center during 2008-2018. Obstetric and neonatal outcomes were compared between cases with placental acute vs. continuous meconium exposure associated changes (columnar epithelial changes and meconium-laden macrophages, respectively). Regression analysis was used to identify independent associations with adverse neonatal outcomes.. The medical records of 294 deliveries at our institution were reviewed, along with medical records of the neonates and the histopathological reports of their placentas. Ninety-two cases were classified as an acute placental reaction to meconium (acute exposure group) and 200 as continuous placental exposure (continuous exposure group). Patient demographics did not differ between groups. Placentas from the continuous exposure to meconium were associated with a higher rate of placental weight <10th percentile (p = 0.03) while the acute exposure group was associated with a shorter time between rupture of membranes and delivery (p = 0.02). and higher rates of non-reassuring fetal heart rate in labor (p = 0.003), and of adverse neonatal outcome (p = 0.02). In multivariable analysis adverse neonatal outcome was associated with acute histologic exposure to meconium independent of background confounders (aOR = 1.51, 95% CI 1.12-3.67).. Acute histological changes of MSAF were independently associated with adverse neonatal outcomes as compared to continuous histologic MSAF.

Topics: Adult; Cohort Studies; Female; Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Israel; Meconium; Placenta; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Retrospective Studies

To study maternal and intrapartum factors associated with adverse neonatal outcome in deliveries complicated by meconium-stained amniotic fluid (MSAF).. A retrospective cohort study of all women with singleton gestations undergoing trial of labor with MSAF during 2011-2020. Deliveries with adverse neonatal outcome were compared with deliveries without.. Overall, 11 329 were included; 376 (3.3%) neonates were diagnosed with adverse neonatal outcomes. Multivariable regression analysis underlined the following factors as independently associated with composite adverse neonatal outcome: pregestational diabetes (odds ratio [OR] 3.21, 95% confidence interval [CI] 1.09-9.43, P = 0.031), polyhydramnios (OR 2.14, 95% CI 1.33-3.44, P = 0.002), fever (OR 2.52, 95% CI 1.67-3.80, P < 0.001), and amnioinfusion (OR 1.73, 95% CI 1.24-2.2438, P = 0.003). When 0, 1, 2, and 3 of the independent risk factors identified were present, the rates of adverse neonatal outcome were 2.9%, 5.5%, 10.0%, and 100%, respectively.. The current study's results suggest that special attention should be payed to deliveries complicated by MSAF and with any of the following factors-polyhydramnios, intrapartum fever, amnioinfusion, and pregestational diabetes.

Topics: Amniotic Fluid; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Pregnancy; Pregnancy Complications; Retrospective Studies

Topics: Female; Fetal Diseases; Fetal Macrosomia; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Peritonitis; Pregnancy

Topics: Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

To investigate the association between meconium-stained amniotic fluid (MSAF) and postcesarean surgical site infections.. This was a secondary analysis of the Maternal-Fetal Medicine Units Network (MFMU) Cesarean Registry. Women with a singleton pregnancy attempting labor or induction of labor, who ultimately had a cesarean delivery, were included in the study. Pregnancies complicated by MSAF (. A total of 18,112 patients were included in the study. 4262 (38%) had meconium-stained amniotic fluid. After accounting for potential confounders in a multivariable logistic regression, meconium-stained amniotic fluid was associated with an increased risk of postoperative surgical site infection (odds ratio 1.16, 95% CI 1.03-1.30).. Meconium-stained amniotic fluid may be associated with an increased risk of postoperative surgical site infection.

Topics: Amniotic Fluid; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Pregnancy; Pregnancy Complications; Surgical Wound Infection

Topics: Amniotic Fluid; Delivery Rooms; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Meconium Aspiration Syndrome; Pregnancy

Topics: Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis; Tuberculosis, Pulmonary

To determine the perinatal outcome of labouring mothers with meconium-stained amniotic fluid (MSAF) compared with clear amniotic fluid at teaching referral hospital in urban Ethiopia.. A prospective cohort study was conducted among labouring mothers with meconium-stained amniotic fluid from July 1 to December 30, 2019. Data was collected with pretested structured questionnaires. A Chi-square test used to check statistical associations between variables. Those variables with a p-value of less than 0.05 were selected for cross-tabulation and binary logistic regression. P-value set at 0.05, and 95% CI was used to determine the significance of the association. Relative risk was used to determine the strength and direction of the association.. Among 438 participants, there where 75(52.1%) primigravida in a stained fluid group compared to112 (38.5%) of the non-stained fluid group. Labour was induced in 25 (17.4%) of the stained fluid group compared to 25(8.6%) of a non-stained fluid group and has a statistically significant association with meconium staining. The stained fluid group was twice more likely to undergo operative delivery compared with a non-stained fluid group. There were more low Apgar scores at birth (36.8% versus 13.2%), birth asphyxias (9% versus 2.4%), neonatal sepsis (1% versus 5.6%), neonatal death (1% versus 9%), and increased admissions to neonatal intensive care unit (6.2% versus 21.5%) among the meconium-stained group as compared to the non-stained group. Meconium aspiration syndrome was seen in 9(6.3%) of the stained fluid group.. Meconium-stained amniotic fluid is associated with increased frequency of operative delivery, birth asphyxia, neonatal sepsis, and neonatal intensive care unit admissions compared to clear amniotic fluid.

Topics: Adult; Amnion; Amniotic Fluid; Apgar Score; Asphyxia Neonatorum; Ethiopia; Female; Hospitals; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intensive Care Units, Neonatal; Labor, Obstetric; Male; Meconium; Meconium Aspiration Syndrome; Mothers; Parturition; Pregnancy; Pregnancy Complications; Prospective Studies; Referral and Consultation; Young Adult

Approximately 8-15% of all infants are born with evidence of meconium-stained amniotic fluid (MSAF). MSAF is a potentially serious sign of fetal compromise and may indicate fetal hypoxia Objectives and aim of the work: The present study was designed to evaluate the relationship between meconium stained amniotic fluid and fetal nucleated red blood cell counts. As well, we aim to evaluate the relationship between the presence of meconium in amniotic fluid and Apgar scores in neonates.. A prospectively case-controlled study was performed on 40 women with clear amniotic fluid as control and 40 women with meconium-stained amniotic fluid as the study group. At delivery, 2 ml of umbilical cord blood was collected and analyzed for nucleated red blood cell (NRBC).. The mean NRBC counts in meconium-stained amniotic fluid was significantly higher than the control group (18.35 ± 7.7 and 9.6 ± 4.96), respectively (p < .001). There were statistically significant differences concerning 1- and 5-min Apgar scores with lower values in the MSAF group (p < .001 and .001, respectively).. Our results support previous studies which indicate the presence of meconium can be associated with chronic fetal hypoxia as demonstrated by elevated fetal NRBC levels.

Topics: Adolescent; Adult; Amniotic Fluid; Apgar Score; Blood Cell Count; Case-Control Studies; Erythroblasts; Female; Fetal Blood; Fetal Hypoxia; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Pregnancy; Young Adult

Topics: Amniotic Fluid; Female; Gastroschisis; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestines; Meconium; Pregnancy

Topics: Delivery Rooms; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Pregnancy

Topics: Delivery Rooms; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Neonatology; Pregnancy; Resuscitation

The objective of this study is to compare pregnancy outcomes in deliveries complicated by primary meconium-stained amniotic fluid (MSAF, present at membrane rupture) and secondary MSAF (transitioned from clear to MSAF during labor).. The medical records and neonatal charts of all deliveries ≥ 37. Of 30,215 deliveries during the study period, 4302 (14.2 %) were included: 3845 (89.4%) in the primary MSAF group and 457 (10.6%) in the secondary MSAF group. The rate of the primary outcome was higher in the secondary MSAF group (p = 0.006). This association remained significant after controlling for background confounders. The secondary MSAF group had higher rate of cesarean deliveries (CDs) and assisted vaginal deliveries. There was a higher rate of composite adverse neonatal outcome when secondary MSAF was diagnosed < 3 vs. >3 h before delivery (p = 0.004).. Secondary MSAF was associated with higher rates of adverse neonatal outcome, CDs, and assisted vaginal deliveries, compared with primary MSAF.

Topics: Amniotic Fluid; Cesarean Section; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Labor, Obstetric; Male; Meconium; Obstetric Labor Complications; Pregnancy; Pregnancy Outcome; Prevalence

To identify peripartum events that may predict the development of short-term neurologic morbidity and mortality among acidemic neonates.. Retrospective case-control study conducted at a single-teaching hospital on data from January 2010 to December 2015. The study cohort group included all acidemic neonates (cord artery pH ≤ 7.1) born at ≥ 34 weeks. Primary outcome was a composite including any of the following: neonatal encephalopathy, convulsions, intra-ventricular hemorrhage, or neonatal death. The study cohort was divided to the cases group, i.e., acidemic neonates who had any component of the primary outcome, and a control group, i.e., acidemic neonates who did not experience any component of the primary outcome.. Of all 24,311 neonates born ≥ 34 weeks during the study period, 568 (2.3%) had a cord artery pH ≤ 7.1 and composed the cohort study group. Twenty-one (3.7%) neonates composed the cases group. Multivariate logistic regression analysis revealed that cases were significantly more likely to have experienced placental abruption (OR 18.78; 95% CI 5.57-63.26), born ≤ 2500 g (OR 13.58; 95% CI 3.70-49.90), have meconium (OR 3.80; 95% CI 1.20-11.98) and cord entanglement (OR 5.99; 95% CI 1.79-20.06). The probability for developing the composite outcome rose from 3.7% with isolated acidemia to 97% among neonates who had all these peripartum events combined with intrapartum fetal heart rate tracing category 2 or 3.. Neonatal acidemia carries a favorable outcome in the vast majority of cases. In association with particular antenatal and intrapartum events, the short-term outcome may be unfavorable.

Topics: Abruptio Placentae; Acidosis; Case-Control Studies; Cohort Studies; Female; Fetal Blood; Humans; Hydrogen-Ion Concentration; Infant; Infant Mortality; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Meconium; Parturition; Peripartum Period; Pregnancy; Retrospective Studies; Seizures

Topics: Delivery Rooms; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intubation, Intratracheal; Meconium; Pregnancy

Meconium peritonitis is a sterile chemical peritonitis preceded by bowel perforation, resulting in meconium leakage and subsequent inflammatory cascade within the peritoneal cavity. The presentation can range from simple failure of the neonate to pass meconium to complications such as persistent pulmonary hypertension, lung hypoplasia, and systemic inflammatory syndrome. The purpose of this article is to review a case of meconium peritonitis while considering its etiology, diagnosis, management, and multidisciplinary team care.

Topics: Adult; Education, Nursing, Continuing; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Perforation; Male; Meconium; Middle Aged; Neonatal Nursing; Nurses, Neonatal; Peritonitis; Practice Guidelines as Topic; Treatment Outcome

To investigate the association between meconium staining and perinatal and neonatal outcomes in pregnancies with gastroschisis.. Retrospective analysis of infants with prenatally diagnosed gastroschisis born in two academic medical centers between 2008 and 2013. Neonatal outcomes of deliveries with and without meconium staining were compared. Primary outcome was defined as any of the following: neonatal sepsis, prolonged mechanical ventilation, bowel atresia or death. Secondary outcomes were preterm delivery, preterm-premature rupture of membranes (PPROM) and prolonged hospital length of stay.. One hundred and eight infants with gastroschisis were included of which 56 (52%) had meconium staining at delivery. Infants with meconium staining had a lower gestational age at delivery (36.3 (±1.4) versus 37.0 (±1.2) weeks, p = 0.007), and a higher rate of PPROM (25% versus 8%, p = 0.03) than infants without meconium. Meconium staining was not significantly associated with the primary composite outcome or with any of its components. After adjustments, meconium staining remained significantly associated with preterm delivery at <36 weeks [odds ratio OR = 4.0, 95% confidence intervals (CI): 1.5-11.4] and PPROM (OR = 3.8, 95%CI: 1.2-14.5).. Among infants with gastroschisis, meconium staining was associated with prematurity and PPROM. No significant increase in other adverse neonatal outcomes was seen among infants with meconium staining, suggesting a limited prognostic value of this finding.

Topics: Adult; Amniotic Fluid; Cohort Studies; Delivery, Obstetric; Female; Gastroschisis; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature; Length of Stay; Meconium; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Retrospective Studies; Staining and Labeling

Anomalous intestinal microbiota development is supposedly associated with development of necrotizing enterocolitis (NEC). Our aim in this study was to identify the intestinal microbiota of patients at risk for NEC.. In a prospective trial that investigated prognostic factors for development of NEC in high-risk neonates (NTR4153), 11 NEC cases were gestational age/birthweight matched with controls (ratio of 1:2). Feces were collected twice a week. We used the first feces sample of each patient (meconium), as well as the last 2 feces samples prior to development of NEC. DNA was extracted, and the bacterial 16S rRNA genes were analyzed on a MiSeq sequencer.. The presence and abundance of Clostridium perfringens (8.4%) and Bacteroides dorei (0.9%) in meconium were increased in neonates who developed NEC compared with controls (0.1% and 0.2%; both species, P < .001). In post-meconium samples, the abundance of staphylococci became negatively associated with NEC development (P = .1 and P = .01 for consecutive samples); Clostridium perfringens continued to be more prevalent in NEC cases. Early enteral feeding and, in particular, breast milk were correlated with an increase in lactate-producing bacilli in post-meconium samples (ρ = -0.45; P = .004).. A NEC-associated gut microbiota can be identified in meconium samples; C. perfringens continues to be associated with NEC from the first meconium till just before NEC onset. In contrast, in post-meconium, increased numbers of staphylococci were negatively associated with NEC. These findings suggest causality but this causality should be verified in trials of induced infection in animals, targeted antibiotics, and/or probiotics.. CALIFORNIA trial, registered under trial number NTR4153 in the Dutch Trial Registry.

Topics: Adult; Cesarean Section; Chorioamnionitis; DNA, Bacterial; Enterocolitis, Necrotizing; Female; Gastrointestinal Microbiome; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Pregnancy; Principal Component Analysis; Prospective Studies; Risk Factors; Young Adult

This is an unusual case in comparison to other sonographically described prenatal cases due to very early diagnosis and surgical intervention following prompt delivery. A 40-year-old pregnant, ultrasonography showed presence of cystic structure in the fetal abdomen that was consistent with intestinal dilatation. At 32 weeks' of gestation, repeat ultrasound showed collapse of the bowel dilatation along with the presence of hyperechogenic fluid in the fetal abdominal cavity. Cesarean section was performed. The clinical utility of this report is the recognition that meconium peritonitis (MP) may be diagnosed in the acute phase with typical ultrasound features, and should be considered in the differential diagnoses of cases presented with reduced fetal movements. Although it appears that morbidity and mortality in MP cases depend upon gestational age, this case report may help to manage similar cases for defining the appropriate delivery time and treatment modality after prenatal identification of the problem.

Topics: Abdomen; Adult; Diagnosis, Differential; Female; Fetal Diseases; Humans; Ileum; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Perforation; Intestinal Volvulus; Male; Meconium; Peritonitis; Pre-Eclampsia; Pregnancy; Prenatal Diagnosis; Ultrasonography, Prenatal

This is a single-center case series about the rare condition of volvulus without malposition and/or malrotation (VWM) in preterm babies. We focus on diagnostic difficulties, and our results should help to distinguish VWM as a distinct entity different from classical volvulus and segmental volvulus.. Medical chart review of infants with VWM from 2003-2012 was used.. A total of 15 patients were identified. All of them had volvulus in the absence of intestinal malposition or other associated intestinal pathologies. All patients were born prematurely. Emergency laparotomy was necessary in all 15 patients. Two groups were identified. Group 1 includes four patients with typical signs of meconium obstruction of prematurity (MOP). Small bowel resection was only necessary in one of these four patients, all survived without residual intestinal lesions. Group 2 consists of 11 patients without signs of MOP-small bowel resection and temporary enterostomy were necessary in all these children. Four patients presented with pneumatosis intestinalis on the abdominal plain film, suggesting necrotizing enterocolitis. Although two infants died, the survivors showed complete recovery.. VWM is a distinct disease of prematurity. When associated with MOP, VWM has a favorable outcome of treatment. In contrast, VWM occurring in the absence of signs of meconium obstruction requires small bowel resection. VWM primarily affects the top of the midgut (ileum). Because of absent malposition, presentation of VWM may be uncharacteristic. Pneumatosis intestinalis in advanced VWM may lead to diagnostic difficulties and a delay in treatment.

Topics: Databases, Factual; Diagnosis, Differential; Digestive System Surgical Procedures; Enterostomy; Gestational Age; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature; Intestinal Obstruction; Intestinal Volvulus; Intestine, Small; Meconium

Topics: Adult; Female; Fetal Diseases; Humans; Imaging, Three-Dimensional; Infant, Newborn; Infant, Newborn, Diseases; Inflammatory Bowel Diseases; Meconium; Meconium Aspiration Syndrome; Peritonitis; Pregnancy; Ultrasonography, Prenatal

Topics: Humans; Ileum; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Male; Meconium; Orchitis; Scrotum

Meconium-stained amniotic fluid (MSAF) is a common occurrence among women in spontaneous labor at term, and has been associated with adverse outcomes in both mother and neonate. MSAF is a risk factor for microbial invasion of the amniotic cavity (MIAC) and preterm birth among women with preterm labor and intact membranes. We now report the frequency of MIAC and the presence of bacterial endotoxin in the amniotic fluid of patients with MSAF at term.. We conducted a cross-sectional study including women in presumed preterm labor because of uncertain dates who underwent amniocentesis, and were later determined to be at term (n = 108). Patients were allocated into two groups: (1) MSAF (n = 66) and (2) clear amniotic fluid (n = 42). The presence of bacteria was determined by microbiologic techniques, and endotoxin was detected using the Limulus amebocyte lysate (LAL) gel clot assay. Statistical analyses were performed to test for normality and bivariate comparisons.. Bacteria were more frequently present in patients with MSAF compared to those with clear amniotic fluid [19.6% (13/66) versus 4.7% (2/42); p < 0.05]. The microorganisms were Gram-negative rods (n = 7), Ureaplasma urealyticum (n = 4), Gram-positive rods (n = 2) and Mycoplasma hominis (n = 1). The LAL gel clot assay was positive in 46.9% (31/66) of patients with MSAF, and in 4.7% (2/42) of those with clear amniotic fluid (p < 0.001). After heat treatment, the frequency of a positive LAL gel clot assay remained higher in the MSAF group [18.1% (12/66) versus 2.3% (1/42), p < 0.05]. Median amniotic fluid IL-6 concentration (ng/mL) was higher [1.3 (0.7-1.9) versus 0.6 (0.3-1.2), p = 0.04], and median amniotic fluid glucose concentration (mg/dL) was lower [6 (0-8.9) versus 9 (7.4-12.6), p < 0.001] in the MSAF group, than in those with clear amniotic fluid.. MSAF at term was associated with an increased incidence of MIAC. The index of suspicion for an infection-related process in postpartum women and their neonates should be increased in the presence of MSAF.

Topics: Adolescent; Adult; Amniotic Fluid; Bacteria; Chorioamnionitis; Cross-Sectional Studies; Endotoxins; Female; Humans; Incidence; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Pregnancy; Pregnancy Complications, Infectious; Puerperal Disorders; Term Birth; Young Adult

To validate established neonatal neutrophil reference ranges (RRs) and determine the utility of serial measurements of neutrophil values in the first 24 hours to predict the absence of neonatal early-onset sepsis (EOS).. Retrospective study of 2073 admissions to the neonatal intensive care unit (2009-2011). Neonates were classified as blood culture-positive, proven EOS (n = 9), blood culture-negative but clinically suspect EOS (n = 292), and not infected (n = 1292). Neutrophil values from 745 not-infected neonates without perinatal complications were selected to validate RR distributions. Positive and negative predictive values were calculated; area under receiver operating characteristic curves (AUCs) were constructed to predict the presence or absence of EOS. Neutrophil value scores were established to determine whether serial neutrophil values predict the absence of EOS.. Seventy-seven percent of admissions to the neonatal intensive care unit were evaluated for EOS: 9 (0.56%) had proven EOS with positive blood culture ≤ 37 hours; 18% had clinically suspect EOS. Neutropenia occurred in preterm neonates, and nonspecific neutrophilia was common in uninfected neonates. The distribution of neutrophil values differed significantly between study groups. The specificity for absolute total immature neutrophils and immature to total neutrophil proportions was 91% and 94%, respectively, with negative predictive value of 99% for proven and 78% for proven plus suspect EOS. Absolute total immature neutrophils and immature to total neutrophil proportions had the best predictability for EOS >6 hours postnatal with an AUC ∼ 0.8. Neutrophil value scores predicted the absence of EOS with AUC of 0.9 and 0.81 for proven and proven plus suspect EOS, respectively.. Age-dependent neutrophil RRs remain valid. Serial neutrophil values at 0, 12, and 24 hours plus blood culture and clinical evaluation can be used to discontinue antimicrobial therapy at 36-48 hours.

Topics: Apgar Score; Asphyxia Neonatorum; Chorioamnionitis; Female; Fetal Membranes, Premature Rupture; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intensive Care Units, Neonatal; Male; Meconium; Neutrophils; Predictive Value of Tests; Pregnancy; Reference Values; Resuscitation; Retrospective Studies; ROC Curve; Sensitivity and Specificity; Sepsis

Topics: Calcinosis; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis; Radiography

Category II fetal heart rate (FHR) tracings are considered indeterminate; thus, improved risk stratification of category II FHR tracings is needed. We estimated whether the presence of meconium increased the risk of adverse neonatal outcomes.. This study was conducted within a prospective cohort of 5000 women with singleton pregnancies who were admitted in labor at term. Pregnancies with category II FHR in the 60 minutes before delivery were included. FHR data were extracted by trained nurses who were blinded to clinical outcome. The exposure was the presence of meconium. The primary outcome was a composite neonatal morbidity defined as ≥1 of the following: neonatal death, neurologic morbidity, respiratory morbidity, hypotension that required treatment, and sepsis. Secondary outcomes were nursery admission, cord pH, 5-minute Apgar score, and components of the composite. Logistic regression was used to adjust for confounders.. Of the 3257 women with category II FHR tracings, 693 women (21.3%) had meconium, and 2564 women (78.7%) did not. Meconium was associated with higher risk of the composite morbidity (adjusted odds ratio, 2.49; 95% confidence interval, 1.78-3.48) and increased risks of the secondary outcomes. The associations remained significant when infants with meconium aspiration syndrome were excluded. Thick meconium was associated significantly with the composite morbidity.. The presence of meconium is associated with an increased risk of neonatal morbidity in women with category II FHR pattern. This clinical factor may assist clinicians in managing category II FHR patterns in labor.

Topics: Adult; Amniotic Fluid; Cardiotocography; Female; Heart Rate, Fetal; Humans; Hypotension; Infant, Newborn; Infant, Newborn, Diseases; Logistic Models; Meconium; Meconium Aspiration Syndrome; Multivariate Analysis; Obstetric Labor Complications; Odds Ratio; Perinatal Death; Pregnancy; Prospective Studies; Risk Assessment; Risk Factors; Sepsis; Young Adult

The aim of the study was to determine whether longitudinal measurements of fecal S100A12, a damage-associated molecular pattern protein, which is released from neutrophils or monocytes under stress, can detect very-low-birth-weight (VLBW) infants at risk for intestinal distress apart from necrotizing enterocolitis.. This prospective study included 46 VLBW infants with intestinal distress and 49 reference patients. Meconium and stool samples were collected prospectively on alternate days for 4 weeks, and fecal S100A12 was measured by enzyme-linked immunosorbent assay.. Gestational age and weight at birth were significantly lower in patients with intestinal distress when compared to unaffected reference infants. Median levels of fecal S100A12 were significantly higher in patients with intestinal distress at onset of disease and before compared with unaffected reference infants. Median levels of fecal S100A12 declined steadily to baseline levels within 2 weeks after disease onset. The ideal cutoff value for identifying patients with intestinal distress within 7 days before disease onset was 60 μg/kg (sensitivity 0.73; specificity 0.55).. Fecal S100A12 levels are increased in VLBW infants with intestinal distress; however, the potential for S100A12 as an early biomarker is largely limited by overlaps between values of infants with intestinal distress and the reference population.

Topics: Biomarkers; Birth Weight; Enzyme-Linked Immunosorbent Assay; Feces; Female; Gestational Age; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Infant, Very Low Birth Weight; Intestinal Diseases; Intestinal Mucosa; Leukocytes; Longitudinal Studies; Male; Meconium; Monocytes; Neutrophils; Prospective Studies; Reference Values; S100 Proteins

To determine perinatal parameters among term newborn infants born by vaginal delivery with meconium-stained amniotic fluid (MSAF) that needed paediatrician assistance.. Paediatricians who were in attendance in the delivery room due to MSAF among term infants completed 775 reports regarding the infants' delivery conditions, and the assistance provided. We defined 'paediatrician attendance needed' for a subgroup of infants for whom we retrospectively determined that paediatrician attendance in the delivery room was required.. 'Paediatrician attendance needed' was determined in 31 (4%) cases. Among cases with documented normal foetal monitor, only 10 (1.8%) were defined as 'paediatrician attendance needed', a percentage significantly lower than among infants born following non-reassuring foetal monitor: 21 (9.7%) (p < 0.001). 'Paediatrician attendance needed' was predicted by non-reassuring foetal monitor [OR 6.02 (CI 2.72-13.31), p < 0.001], maternal fever [OR 6.34 (1.92-20.92), p = 0.002] and younger maternal age (for every year) [OR 0.889 (CI 0.82-0.96), p = 0.003].. Term newborn infants born by vaginal delivery with MSAF with documented normal tracing foetal monitor are at low risk of the need for paediatrician assistance. Paediatrician attendance in the delivery room in labour involving MSAF should be recommended when non-reassuring foetal monitor tracing is observed and should also be considered when maternal fever is recorded, and/or thick meconium is observed.

Topics: Amniotic Fluid; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Pediatrics; Retrospective Studies

The stability of extemporaneously prepared acetylcysteine 1% and 10% solutions for treatment of meconium ileus was evaluated.. Acetylcysteine 1% (10-mg/mL) and 10% (100-mg/mL) solutions were prepared by mixing 3 and 10 mL, respectively, of commercially available 20% acetylcysteine solution with a sufficient quantity of bacteriostatic 0.9% sodium chloride for injection to make a final volume of 60 mL. Three identical samples of each concentration were prepared, placed in 2-oz amber plastic prescription bottles, and stored at 20-25 °C. Samples were assayed in duplicate using high-performance liquid chromatography and inspected for changes in color, odor, and pH immediately after preparation and at 7, 14, 30, 60, and 90 days. Stability was defined as retention of at least 90% of the initial concentration.. At least 90% of the initial concentration of acetylcysteine was retained in both formulations for 60 days. No appreciable change from the initial pH occurred in the acetylcysteine 1% or 10% solution during the first 60 days, but there was a notable change in pH after 90 days in both formulations. Neither solution was stable at day 90. There was no detectable change in color at 90 days; however, the odor of hydrogen sulfide was more pungent than on previous study days.. Extemporaneously prepared solutions of acetylcysteine 1% (10 mg/mL) and 10% (100 mg/mL) prepared with bacteriostatic 0.9% sodium chloride for injection were stable for at least 60 days when stored in plastic amber bottles at room temperature.

Topics: Acetylcysteine; Administration, Oral; Chromatography, High Pressure Liquid; Drug Stability; Humans; Ileus; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Solutions

A nationwide survey on neonatal surgery conducted by the Japanese Society of Pediatric Surgeons has demonstrated that the mortality of neonatal intestinal perforation has risen over the past 15 years. The incidence of intestinal perforation in extremely low-birthweight (ELBW) neonates has been increasing as more ELBW neonates survive and as the live-birth rate of ELBW has increased. In contrast to necrotizing enterocolitis (NEC) and focal intestinal perforation (FIP), the pathogenesis of meconium-related ileus, defined as functional bowel obstruction characterized by delayed meconium excretion and microcolon, remains unclarified.. The histology of 13 ELBW neonates with intestinal perforation secondary to meconium-related ileus was reviewed, and the radiology of 33 cases of meconium-related ileus diagnosed on contrast enema was reviewed. Specimens obtained from 16 ELBW neonates without gastrointestinal disease served as age-matched controls for histological assessment.. The size of the ganglion cell nucleus in meconium-related ileus and in control subjects was 47.3 ± 22.0 µm(2) and 37.8 ± 11.6 µm(2), respectively, which was not significantly different. In all cases of meconium-related ileus, contrast enema demonstrated a microcolon or small-sized colon, with a gradual caliber change in the ileum and filling defects due to meconium in the ileum or colon, showing not-identical locations of caliber changes and filling defects.. Morphological immaturity of ganglia was not suggested to be the pathogenesis of meconium-related ileus. Impaction of inspissated meconium is not the cause of obstruction, but the result of excessive water absorption in the hypoperistaltic bowel before birth, although the underlying mechanism responsible for the fetal hypoperistalsis remains unclear.

Topics: Colon; Colonic Diseases; Contrast Media; Diagnosis, Differential; Enema; Ganglia, Sympathetic; Gestational Age; Humans; Ileus; Infant, Newborn; Infant, Newborn, Diseases; Infant, Very Low Birth Weight; Laparotomy; Meconium; Prognosis; Radiography, Abdominal

Fetal bowel intrauterine perforation causes sterile inflammation of the peritoneum, known as meconium peritonitis. In some cases the perforation closes spontaneously, thus forming a meconium pseudocyst between the intestinal loops and the omentum. Meconium peritonitis, complicated by pseudocyst formation, should always be considered when a fetal abdominal mass with diverse echogenicity and hyperechogenic calcifications is observed on prenatal ultrasound. Usually, this is associated with ascites and/or polyhydramnios. The differential diagnosis necessitates exclusion of all other fetal abdominal tumors. We present a case report of meconium pseudocyst diagnosed prenatally at 32 weeks of gestation which was successfully treated by surgery after birth.

Topics: Abdomen; Abdominal Neoplasms; Adult; Cysts; Female; Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Peritonitis; Pregnancy; Ultrasonography, Prenatal; Uterine Perforation

Meconium abnormalities are characterized by a wide spectrum of severity, from the meconium plug syndrome to the complicated meconium ileus associated with cystic fibrosis. Meconium Related Ileus in absence of Cystic Fibrosis includes a combination of highly viscid meconium and poor intestinal motility, low grade obstruction, benign systemic and abdominal examination, distended loops without air fluid levels. Associated risk factors are severe prematurity and low birth weight, Caesarean delivery, Maternal MgSO4 therapy, maternal diabetes. In the last 20 yrs a new specific type of these meconium related obstructions has been described in premature neonates with low birth weight. Its incidence has shown to increase while its management continues to be challenging and controversial for the risk of complicated obstruction and perforation.. Among 55 newborns admitted between 1992-2008 with Meconium Related Ileus as final diagnosis, data about Low Birth Weight infants (LBW < 1500 g) were extracted and compared to those of patients ≥ 1500 g. Hischsprung's Diseases and Cystic Fibrosis were excluded by rectal biopsy and genetic probe before discharge. A softening enema with Gastrografin was the first option whenever overt perforation was not present. Temporary stoma or trans appendiceal bowel irrigation were elected after unsuccessful enema while prompt surgical exploration was performed in perforated cases. NEC was excluded in all operated cases. Data collected were perinatal history and neonatal clinical data, radiological signs, clinical course and complications, management and outcome.. 30 cases with BW ≥ 1500 g had an M/F ratio 16/14, Mean B.W. 3052 g, Mean G.A. 37 w Caesarean section rate 40%. There were 10 meconium plug syndrome, 4 small left colon syndromes, and 16 meconium ileus without Cystic Fibrosis. Five cases were born at our institution (inborn) versus 25 referred after a mean of 2, 4 Days (1-7) after birth in another Hospital (outborn). They were managed, after a Gastrografin enema with 90% success rate, by 1 temporary Ileostomy and 2 trans appendiceal irrigation. 25 cases with BW< 1500 g (LBW) had M/F ratio 11/14, Mean B.W. 818 g, Mean G.A. 27 w, Caesarean section rate 70%, assisted ventilation 16/25. There were 8 inborn and 17 outborn. Gastrografin enema was successful in 6 out 8 inborn infants only, all referred within one week from birth. There were 12 perforations mainly among late referred LBW outborn.. Meconium Related Ileus without Cystic Fibrosis responds to conservative management and softening enema in most of mature infants. In LBW clinical course is initially benign but as any long standing bowel obstruction management may present particular challenges. Clinical and plain radiographic criteria are reliable for making diagnosis and testing for Cystic Fibrosis may not be indicated. Enema may be resolutive when performed in a proper environment. Perforated cases may be confused with NEC which is excluded by clinical history, no signs of sepsis, lab signs missing, abdominal signs missing, typical radiological signs missing. The higher complication rate is recorded among cases delivered and initially managed in Neonatal Units without co-located Surgical Facilities. Early diagnosis and aggressive medical therapy may lead to higher success rate and help avoiding surgical interventions. Surgical therapy in uncomplicated cases, unresponsive to medical management, should be minimally aggressive.

Topics: Cystic Fibrosis; Female; Follow-Up Studies; Humans; Ileus; Incidence; Infant, Low Birth Weight; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature; Infant, Premature, Diseases; Italy; Male; Meconium; Prognosis; Retrospective Studies; Survival Rate

Pineal cysts are benign glial uniloculated or multiloculated fluid-filled sacs located in the pineal gland region. Small pineal cysts are often found incidentally in healthy adults in 1.5-10.8%. Large cysts may cause neurological problems due to pressure exertion on adjacent structures.. We have used prospective, observational study of an inception cohort of 16 adolescents of mean age 21.69 years (SD=±0.87) with mild (68.7%) to moderate (31.3%) HIE: 7 girls (43.8%) and 9 (56.3%) boys, born with mean gestational age of 35.75 weeks (SD=±3.80) and mean birthweight of 2 644 g (SD=±815). HIE was confirmed by presence of abnormal CTG and/or meconium and/or Apgar scores less than 7 at 5 minutes and/or need for resuscitation and/or cord pH less than 7.2 and /or BE more than -15. The clinical assessment of HIE was done according to the Sarnat-Sarnat scoring. Neonatal data, including EEG and imaging data, were collected. Adolescents were scanned with 3T Magnetom Trio Tim, Siemens, head coil 12 channels, regular sequences and sagittal 3D magnetization-prepared rapid acquisition gradient echo (MPRAGE) sequence with voxel size 1 mm3. Neurological outcome was determined.. In 1 patient we found cortical dysplasia and 1 had a panic attack hence their data were omitted. In the group of 14 we have incidentally found in 5 patients a larger, asymptomatic pineal cysts with the overall incidence of 36%. Other MR findings in the group were in 50% white matter injury, in 50% thinner corpus callosum. No statistically significant difference between neonatal cUS and late follow-up MRI (p=0.881) was found. Correlation was not significant with Spearman correlation coefficient 0.201. Presence of pineal cysts was linked to thinner corpus callosum (p=0.005).. We propose that larger pineal cyst, in the absence of other imaging findings except for thinner corpus callosum, is a benign consequence of mild hypoxia in a near-term brain. Our findings warrant a larger study.

Topics: Adolescent; Apgar Score; Cohort Studies; Corpus Callosum; Cysts; Female; Follow-Up Studies; Humans; Hypoxia-Ischemia, Brain; Incidence; Infant, Newborn; Infant, Newborn, Diseases; Leukoencephalopathies; Magnetic Resonance Imaging; Male; Meconium; Pineal Gland; Severity of Illness Index; Young Adult

Based on the results of two large RCTs, guidelines from NRP/AAP, ILCOR, ACOG, and from Argentinean scientific societies for intrapartum and postpartum management of pregnancies with Meconium Stained Amniotic Fluid (MSAF) have radically changed. However, there are no data as to current delivery room management of infants born through MSAF.. 1) To assess current delivery room approaches in infants born through MSAF in Argentina; 2) To evaluate the adherence to NRP/AAP recommendations among different centers.. A 20-question anonymous web-mail based survey was sent to 121 institutions with > or = 500 births a year.. The response rate was 63% representing 182,540 deliveries/year (26% of the total number of births in the country). Among the surveyed institutions, 24% were located in the city of Buenos Aires and 72% were public hospitals. Although no longer recommended, the following procedures are frequently performed: 1) Oro-nasopharingeal suctioning of meconiumstained infants before the delivery of the shoulders: sometimes, 50% of centers; always, 7 %. 2) Routine tracheal suctioning in vigorous infants, 30%. 3) Glottis exposure under laryngoscopy, 13 % for thin-consistency MSAF and 43% for thick-consistency MSAF. On the contrary, and although strongly recommended, only 69% of depressed infants have tracheal suctioning before ventilation. Up to 7% of centers perform other non recommended procedures such as chest compression and pressure over the larynx, to avoid breathing, and gastric lavage.. In spite of not being currently recommended, intrapartum suction and postnatal intubation and suction of vigorous infants with MSAF are commonly performed in Argentina while in depressed newborns the latter procedure is not always carried out. Our study confirms the frequent gaps observed between scientific evidence, guidelines and clinical practice.

Topics: Amniotic Fluid; Argentina; Cross-Sectional Studies; Delivery Rooms; Guideline Adherence; Humans; Infant Care; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Surveys and Questionnaires

Regional guideline for immediate tracheal suctioning (ITS) in vigorous and non-vigorous infants born through meconium-stained amniotic fluid (MSAF) has been established in 2003. The objective of this study was to evaluate guideline application.. Prospective cohort.. The first part of the study was a short survey about ITS practices in maternity hospitals then, management and early evolution of babies born through particulate MSAF was evaluated by questionnaire.. Among 6761 neonates, 199 (3%) were born with MSAF. Early clinical evaluation showed 52 (26%) non-vigorous neonates; 22 of them (42%) have had an ITS. One hundred and forty-seven neonates were vigorous (74%); 27 of them (18%) have had an ITS. Implementation of recommendations in non-vigorous babies was better in maternities of level III, while they were lower in maternities of level IIA for vigorous babies. Among 52 non-vigorous children, eight had a meconium aspiration syndrome (MAS), including five who had an ITS. One MAS occurred in vigorous babies but infection could not be excluded.. Recommendations for ITS were implemented in 70% of cases but only in 42% of cases in non-vigorous babies. We have to improve formation and circulation of new recommendations.

Topics: Amniotic Fluid; Female; Guideline Adherence; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Prospective Studies; Suction

Topics: Abdominal Cavity; Calcinosis; Cysts; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature; Meconium; Polyhydramnios; Pregnancy; Radiography; Ultrasonography

Meconium peritonitis is a sterile chemical peritonitis resulting from intestinal perforation in-utero. We present a preterm male neonate weighing 1820 g in whom foetal meconium peritonitis was diagnosed by antenatal utrasonogram. Examination of the newborn in the immediate postnatal period revealed a firm lump of size 5 x 3 cm in the right lumbar and umbilical area. Rest of the abdomen was normal without any clinical evidence of intestinal obstruction. X-ray of abdomen done at 3 hours of life showed a cystic mass with calcified margin. Ultrasonography of abdomen ruled out any definite cause of intestinal obstruction and perforation. He was kept on conservative management. At 11 hours of life the neonate passed a small sticky white mucus plug per rectum followed by black colored meconium of normal consistency 2 hours later. The bowel habit remained regular thereafter. Screening for intrauterine infections and cystic fibrosis was negative. He is under regular follow-up and is now 6 months old with normal bowel habit. A lump of size 2 x 2 cm is still palpable and a small calcified mass is persistent in x-ray. Role of an intestinal mucus plug as the potential factor for intestinal obstruction and subsequent perforation has been highlighted in the present case.

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Perforation; Male; Meconium; Peritonitis; Premature Birth; Treatment Outcome; Ultrasonography

We evaluated acute neonatal morbidities in the delivery room associated with primary cesarean performed prior to labor and in the first or second stages of labor. A retrospective cohort study was conducted on subjects undergoing term, primary cesareans at the Women's Pavilion, Miller Children's Hospital in Long Beach, California from 2000 to 2007. Acute neonatal morbidities were tabulated as a function of time during labor when cesarean was performed. Composite neonatal morbidity was defined as the presence of at least one of the following: low 5-minute Apgar score, need for intubation, and/or admission to neonatal intensive care unit. One thousand forty-five subjects delivered by cesarean without labor, 3098 in first stage, and 951 in second stage. Five-minute Apgar score < 7 was more common in cesareans performed during second stage than during first stage or without labor [3/1045 (0.3%) versus 28/3098 (0.9%) versus 12/951 (1.3%), P = 0.039]. Composite neonatal morbidity was not significantly different among the stages. Acute neonatal morbidities were not affected by the presence or absence of labor. Potential long-term sequelae require further study.

Topics: Adult; Apgar Score; Cesarean Section; Delivery Rooms; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intensive Care Units, Neonatal; Intubation, Intratracheal; Labor Stage, First; Labor Stage, Second; Meconium; Pregnancy; Resuscitation; Young Adult

The significance of meconium plug syndrome is dependent on the underlying diagnosis. The incidence of pathologic finding, particularly Hirschsprung's disease, contributing to the presence of these plugs, has been debated. However, there are little recent data in the literature. Therefore, we reviewed our experience with meconium plugs as a cause of abdominal distension to evaluate the associated conditions and incidence of Hirschsprung's disease.. We reviewed the records of newborns with meconium plugs found in the distal colon on contrast enema from 1994 to 2007. Demographics, radiologic findings, histologic findings, operative findings, and clinical courses were reviewed.. During the study period, 77 patients were identified. Mean gestational age was 37.4 weeks and birth weight, 2977 g. Hirschsprung's disease was found in 10 patients (13%). One had ultrashort segment disease and another had total colonic aganglionosis. Maternal diabetes was identified in 6 patients. No patients were diagnosed with cystic fibrosis, meconium ileus, malrotation, or intestinal atresia.. Meconium plugs found on contrast enema are associated with a 13% incidence of Hirschsprung's disease in our experience. Although all patients with plugs and persistent abnormal stooling patterns should prompt a rectal biopsy and genetic probe, the incidence of Hirschsprung's and cystic fibrosis may not be as high as previously reported.

Topics: Comorbidity; Female; Gestational Age; Hirschsprung Disease; Humans; Ileus; Incidence; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Length of Stay; Male; Meconium; Pregnancy; Pregnancy in Diabetics; Retrospective Studies; Syndrome

About one-half of patients with meconium ileus (MI) present with a complication such as volvulus, atresia, meconium peritonitis or giant cystic meconium peritonitis. The treatment of these complications requires surgery. However, the preoperative diagnosis of complicated MI is difficult. We describe two neonates with complicated small-bowel obstruction, one with MI related to cystic fibrosis and the other not related to cystic fibrosis. In both, contrast enema depicted a spiral appearance of the distal small bowel, which at surgery proved to be the result of volvulus associated with antenatal bowel perforation. This appearance of the small bowel on contrast enema in this clinical setting has not been previously described. The recognition of this spiral appearance of the distal small bowel suggests the need for surgery.

Topics: Contrast Media; Cystic Fibrosis; Enema; Female; Humans; Ileus; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Perforation; Intestinal Volvulus; Intestine, Small; Meconium; Radiography, Abdominal; Ultrasonography, Interventional

The etiology of meconium obstruction without cystic fibrosis is unclear. Interstitial cells of Cajal (ICC) function as pacemakers in gut motility and may play a role in the pathophysiology of the disease.. The ICC were examined by immunohistochemical staining with anti-c-kit antibody in the bowel walls of 6 neonates who had meconium obstruction without cystic fibrosis, and the results were compared with specimens from normal neonates (n = 2).. Six patients underwent ileostomy between 2 and 15 days after birth, and 5 of them presented with microcolon. Ganglion cells were present in the ileum and colon. Whereas ICC were evenly distributed in the control specimens, they were not seen at the time of ileostomy in the colons of 2 patients, and the other 4 showed scanty distribution in muscle layers. However, ileum showed normal distribution of ICC in all patients. The ileostomies were closed between 39 and 104 days of age, and the ICC distribution was changed to a normal pattern in the colons of all 6 patients. Their bowel movements were restored to normal after closure.. The findings of this study suggest that delayed maturity of ICC may be a cause of meconium obstruction without cystic fibrosis.

Topics: Coiled Bodies; Colonic Diseases; Female; Gastrointestinal Motility; Humans; Ileal Diseases; Ileostomy; Immunohistochemistry; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium

This study was undertaken to better define the timing of neurologic insult in neonates with early-onset seizures through evaluation of neonatal nucleated red blood cell levels.. Medical records and the International Classification of Diseases, Ninth Revision codes were used to identify all term neonates with neonatal convulsions who were delivered at our institution (January 1, 1990-December 31, 1995). Each neonate with early-onset seizures was matched to the next 3 neonates who met the following criteria: gestational age > or =37 weeks, no early-onset seizures, birth weight > or =800 g, umbilical artery pH > or =7.25, and a 5-minute Apgar score >7. Demographic characteristics, clinical factors, and mean initial nucleated red blood cell counts were compared between groups.. During the 6-year study period, there were a total of 36, 490 singleton term deliveries of infants who were alive at birth. Forty-five (0.1%) of these neonates had early-onset seizures. Thirty neonates with early-onset seizures met the inclusion criteria. Mean nucleated red blood cell counts (number of nucleated red blood cells per 100 white blood cells) for neonates with early-onset seizures were significantly increased compared with those of control neonates (18.4 +/- 22.0 vs 4.6 +/- 4.5; P <.0008).. Our findings are suggestive of the hypothesis that neurologic injury leading to early-onset seizures often occurs before the intrapartum period.

Topics: Amniotic Fluid; Erythroblasts; Erythrocyte Count; Fetal Blood; Humans; Hydrogen-Ion Concentration; Incidence; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Reference Values; Seizures

We sought to compare obstetric and neonatal complications among great-grand multiparous, grand multiparous, and multiparous women.. One hundred thirty-three great-grand multiparas, 314 grand multiparas, and 2195 multiparas who were delivered of their infants between 1988 and 1998 were selected for the study. To facilitate comparison, the patients were all >35 years old and had similar socioeconomic characteristics.. The incidence of malpresentation at the time of delivery, maternal obesity, anemia, preterm delivery, and meconium-stained amniotic fluid increased with higher parity, whereas the rate of excessive weight gain and cesarean delivery decreased. Compared with grand multiparas, great-grand multiparas had significantly elevated risks for abnormal amounts of amniotic fluid, abruptio placentae, neonatal tachypnea, and malformations but lower rates of placenta previa (P <.05). The incidence of postpartum hemorrhage, preeclampsia, placenta previa, macrosomia, postdate pregnancy, and low Apgar scores was significantly higher in grand multiparas than in multiparas, whereas the proportion of induction, forceps delivery, and total labor complications was significantly lower than in the multiparous group (P <.05). Similar frequency of maternal diabetes, infection, uterine wall scar rupture, variations in fetal heart rate, fetal death, and neonatal mortality was found in the 3 groups.. Both high-parity groups have their own risk factors, but the rate of some complications decreases with higher parity. In addition, perinatal mortality remains low in these patients, and therefore, under satisfactory socioeconomic and health care conditions, high parity should not be considered dangerous.

Topics: Adult; Anemia; Cesarean Section; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Labor Presentation; Meconium; Obesity; Obstetric Labor, Premature; Parity; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Weight Gain

Our purpose was: (1) to determine whether assessment of amniotic fluid index in high risk patients with a reactive nonstress test (NST) allowed improved recognition of the fetus at risk for perinatal morbidity than a reactive NST alone; and (2) to determine the optimal low amniotic fluid index (AFI) which should prompt clinical concern. The last NST performed within a week of delivery and amniotic fluid index were retro-spectively compared with various indices of perinatal morbidity. In fetuses with a reactive NST, decreasing AFI was directly correlated with a risk of 5-minute Apgar score of less than 7 and delivery for fetal distress. When various subgroupings of AFI were compared, 7 cm or greater appeared to have a better inverse correlation with the indices of morbidity than lower cut-off values. The addition of AFI assessment to the standard NST allows better prediction of perinatal morbidity than the NSTs alone. Seven centimeters appears to be a reasonable cut-off for clinical concern.

Topics: Amniotic Fluid; Apgar Score; Cesarean Section; False Positive Reactions; Female; Fetal Distress; Fetal Monitoring; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intensive Care Units, Neonatal; Meconium; Predictive Value of Tests; Pregnancy; Pregnancy Outcome; Pregnancy, High-Risk; Risk Factors

The objectives of this study were to identify, by means of two third-trimester scans, fetuses with ultrasound evidence of inadequate growth but who were born with birth weights above the 10th centile for gestational age; and to determine if these infants constitute a high-risk group by comparing the incidence of obstetric intervention, of intrapartum complications and of neonatal morbidity between this group and the group of infants who showed no ultrasound evidence of intrauterine growth restraint. A total of 285 women with singleton pregnancies who were referred for a third-trimester ultrasound examination were included in this prospective study. Fetal weight was estimated by ultrasound twice in the third trimester and at each examination was assigned a centile score. A fall of > 20 centiles was taken as evidence of inadequate growth. The outcomes measured were the incidence of abnormal umbilical artery Doppler, induction of labor, meconiumstaining of the liquor, intrapartum fetal blood sampling, operative vaginal delivery, Cesarean section, Apgar score of < 7 at 5 min and admission to the neonatal intensive care unit. Seventy-five patients showed a drop of > 20 centiles between the first and second scans. The incidence of admission to the neonatal intensive care unit was greater in those infants who had ultrasound evidence of growth restraint. We conclude that infants of normal birth weight with inadequate growth diagnosed on ultrasound are not at increased risk, they have an increased incidence of admission to the neonatal intensive care unit, and they are more commonly found in mothers with diabetes mellitus.

Topics: Apgar Score; Birth Weight; Cesarean Section; Delivery, Obstetric; Embryonic and Fetal Development; Female; Fetal Blood; Fetal Growth Retardation; Gestational Age; Humans; Incidence; Infant, Newborn; Infant, Newborn, Diseases; Intensive Care, Neonatal; Ireland; Labor, Induced; Meconium; Pregnancy; Pregnancy in Diabetics; Pregnancy Trimester, Third; Prospective Studies; Risk Factors; Ultrasonography, Prenatal; Umbilical Arteries

A case of meconial disease not associated with mucoviscidosis registered in 0.08% of perinatal autopsies is described in a premature girl who died 46 hours after her birth. Productive exudative meconial peritonitis that had developed due to intestinal wall perforation caused by meconium plug pressure was detected on the section. Microscopically, there were abundant squamous epithelial scales in the fibrinous exudate and commissures, whereas in the submucosal layer of the intestinal wall there were productive aseptic meconial granulomas whose components are squamous epithelial scales in addition to cellular elements. Searches for granulomas are made concurrently with examination of great quantities of histologic sections, but their detection is valuable for differential diagnosis of newborn ulcerous enterocolitis.

Topics: Enterocolitis; Female; Granuloma; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Diseases; Meconium

The nonstress test (NST) remains in widespread use for antepartum fetal surveillance. Our institutional experience with 14,028 patients and 38,645 tests over eight years reveals a fetal death rate of 2.6 per 1000 within seven days of a reactive NST. The autopsy findings of 53 fetal deaths are presented. The most common findings, in descending order of frequency, were meconium aspiration, perinatal infection, and abnormal umbilical cord position. These findings support changes we have made in our antepartum assessment protocols.

Topics: Female; Fetal Death; Fetal Diseases; Fetal Monitoring; Heart Rate, Fetal; Humans; Infant, Newborn, Diseases; Infections; Meconium; Pneumonia, Aspiration; Pregnancy; Umbilical Cord

Following a legal action that resulted from the death of a newborn with the meconium aspiration syndrome, I investigated the incidence and management at a community hospital of the meconium-stained newborn during March in each of the years 1973 through 1985. During March in 1973 through 1981, 4.3% of all live births (1368) were meconium stained. After the newborn's death, which initiated a period of legal negotiations, the incidence of meconium staining increased to 14.4% among 582 live births during March of 1982 through 1985. Laryngoscopy increased to include 64.3% of meconium-stained newborns, and endotracheal suctioning was associated with laryngoscopy in 72.2% of the patients. Also, oxygen administration to newborns with and without meconium staining increased from 10.5% in March of 1973 through 1981 to 45.7% in March of 1982 through 1985. There was no improvement in outcome from the increased recognition and more aggressive management. While the issuance of medical guidelines alone had little effect on the incidence and care of the meconium-stained newborn, the combination of the legal imperative with medical guidelines had a profound and corruptive effect.

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Jurisprudence; Meconium; Retrospective Studies; United States

To compare high frequency positive pressure ventilation (HFV) to conventional ventilation (CV) in experimental meconium aspiration syndrome (MAS) adult rabbits were randomly assigned to one of four groups: sham (G1) n = 10, control (G2) n = 12, CV (G3) n = 6, and HFV (G4) n = 6. All animals were stabilized on an FI O2 of 0.70 after a tracheostomy and arterial line were placed. The alveolar-arterial oxygen difference (A-aDO2) was calculated for each blood gas measurement and mean airway pressure (MAP) measured in CV and HFV at the time of each blood gas. Human meconium (2 ml/kg of 25% solution) was instilled intratracheally (MI) in groups 2-4. Group 3 was then placed on conventional ventilation with a rate of 40 BPM while Group 4 with a rate of 400 BPM. Analysis of variance was used to compare A-aDO2 and MAP. There was no significant difference between group 4 and group 2, while there was a significant difference between group 3 and groups 2 and 4. Sustained inflation of 25 cm H2O as used for 20 seconds was used before HFV in a fifth group (n = 6) that was added to the study and was otherwise identical to HFV. There was no significant difference between the fifth group and group 2 or group 4. Our findings indicate HFV is not efficacious in experimental MAS whether or not sustained inflation is used.

Topics: Animals; Disease Models, Animal; Humans; Infant, Newborn; Infant, Newborn, Diseases; Inhalation; Intermittent Positive-Pressure Ventilation; Lung Diseases; Meconium; Oxygen; Positive-Pressure Respiration; Rabbits; Syndrome

Topics: Amniotic Fluid; Apgar Score; Embryonic and Fetal Development; Female; Humans; Infant, Low Birth Weight; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Pregnancy; Risk

Topics: Amniotic Fluid; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Obstetric Labor Complications; Pregnancy

Sodium nitroprusside was administered to 58 neonates, including 11 with severe respiratory distress syndrome, 15 with persistent pulmonary hypertension of the newborn, 28 with clinical shock, three with systemic hypertension, and two with pulmonary hypoplasia, all refractory to conventional intensive therapy. Nitroprusside was infused at 0.2 to 6.0 micrograms/kg/min for periods of 10 minutes to 126 hours. Infants with severe respiratory distress syndrome had increased PaO2 and decreased PaCO2 or peak inspiratory pressure, and nearly all (82%) survived. Infants with persistent pulmonary hypertension of the newborn had variable responses; improvement did not correlate with survival, but survival (47%) was identical to that in an earlier series of infants given tolazoline. Infants in shock had improved perfusion, urine output, and serum bicarbonate levels, and these responses were significantly related to survival. Hypertension was controlled in all three hypertensive infants. Adverse effects were very uncommon. Toxic effects were not observed. Sodium nitroprusside is effective and can be used safely in circulatory disorders in the neonate.

Topics: Bicarbonates; Carbon Dioxide; Drug Evaluation; Ferricyanides; Hemodynamics; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infusions, Parenteral; Inhalation; Lung; Lung Diseases; Meconium; Nitroprusside; Oxygen; Persistent Fetal Circulation Syndrome; Respiratory Distress Syndrome, Newborn; Shock

Topics: Asphyxia Neonatorum; Humans; Hypoglycemia; Infant, Newborn; Infant, Newborn, Diseases; Infections; Meconium; Pneumonia, Aspiration; Surgical Procedures, Operative; Thyroid Gland; Thyroid Hormones; Thyrotropin; Thyroxine; Thyroxine-Binding Proteins; Triiodothyronine; Triiodothyronine, Reverse

Topics: Adolescent; Adult; Amniocentesis; Female; Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infant, Postmature; Meconium; Middle Aged; Pregnancy; Pregnancy, Prolonged

Topics: Asphyxia Neonatorum; Congenital Abnormalities; Female; Fetal Growth Retardation; Glucose; Hematologic Diseases; Hemorrhage; Humans; Hypoglycemia; Hypothermia; Infant Care; Infant Food; Infant, Newborn; Infant, Newborn, Diseases; Infant, Small for Gestational Age; Lung Diseases; Meconium; Pregnancy; Respiratory Distress Syndrome, Newborn; Terminology as Topic; Water-Electrolyte Balance

Results from a previous epidemiologic study indicate that marijuana use near term may elevate risk of abnormal progress of labor and meconium staining. We conducted a study of the association of self-reported marijuana use and perinatal problems in a series of 313 women enrolled in a home-birth center. The 41 marijuana users were similar to non-users with respect to most potentially confounding factors, but users had lower mean income and exhibited more tobacco and alcohol use during pregnancy than non-users. Users experienced slightly elevated rates of dysfunctional labor (43% vs. 35% in non-users), precipitate labor (13% vs. 8%) and meconium staining (17% vs. 13%); differences with respect to most other outcomes were smaller or nonexistent. The observed differences were smaller in both relative and absolute terms than those reported by the earlier study, and were little changed upon adjustment for potentially confounding factors (including alcohol use, cigarette use, parity and income). After accounting for statistical variation, the results appear consistent with the earlier findings but further research is recommended.

Topics: Adult; Birth Weight; Cannabis; Female; Home Childbirth; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Obstetric Labor Complications; Pregnancy; Regression Analysis

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium

Topics: Apgar Score; Female; Fetal Growth Retardation; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Meconium; Pneumonia, Aspiration; Pregnancy; Resuscitation

Topics: Colon; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Radiography

Obstetric literature deals with meconium stained amniotic fluid (AF) in various ways when judging it as an indicator of fetal distress. This evidently reflects the difficulty of finding overt relations between measurable alterations in the condition of the fetus or of the newborn infant and the amount of meconium passed into the AF. Nor is the moment predictable by means of fetal monitoring when meconium is passed. Discussing these problems in the light of the consecutive course of events resulting finally in meconium aspiration some of the discrepancies can be explained without difficulty. Considering also the kinetics of formation and excretion of AF the distinction of 3 variants of meconium aspiration syndrome is possible: 1. late meconium aspiration syndrome in non-asphyctic infants, 2. late meconium aspiration syndrome in asphyctic infants, 3. "connatal" meconium aspiration syndrome.

Topics: Amniotic Fluid; Asphyxia Neonatorum; Humans; Infant, Newborn; Infant, Newborn, Diseases; Inhalation; Kinetics; Meconium; Respiration; Syndrome

MAS can be divided into 2 stages, distinguishable with respect to morphology of the lungs, clinical symptoms and laboratory data. The reason for the vasoconstriction of the pulmonary vascular bed typical for stage 2 is not yet fully understood. It seems, however, plausible that meconium contains substances (enzymes?) which may trigger the release or the synthesis of vasoactive compounds during the process of an aseptic inflammation. Cleaning the upper respiratory tract of an infant with meconium in the amniotic fluid immediately after birth is the most effective step in the prevention of MAS. This measure has led to a dramatic decline in both morbitity and mortality of the disease. In rare instances rinsing of the trachea with saline can help to remove considerable amounts of meconium too thick and sticky to be removed by simple suction.

Topics: Airway Obstruction; Animals; Humans; Hypoxia; Infant, Newborn; Infant, Newborn, Diseases; Inhalation; Lung; Meconium; Mediastinal Emphysema; Partial Pressure; Pneumothorax; Pulmonary Emphysema; Rabbits; Radiography; Respiration; Respiration, Artificial; Syndrome; Therapeutic Irrigation

Topics: Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Pneumonia, Aspiration; Pregnancy

A prospective study, followed by a retrospective audit, was made of the radiographs and clinical features of 225 consecutive neonates with abdominal distension presenting during a period of 4 years. More than one major cause for the distension was found in a third of cases. Excluding cases of ano-rectal atresia, diagnostic difficulties were encountered in 31% of cases and, occasionally, the diagnosis was revised several times as investigations proceeded. Neuhauser's sign of 'bubbly' meconium is unreliable, being found in cases of meconium ileus, ileal atresia, Hirschsprung's disease and necrotising enterocolitis. Concomitant small-bowel atresia should be suspected in all cases of meconium ileus; intestinal malrotation should be considered in association with duodenal and intestinal atresias. In the absence of an obvious anatomical defect, it is difficult to differentiate between the various causes of functional obstruction by radiological means alone and all such infants should be referred to a specialised centre for intensive investigation and treatment. Very often, the skills of a neonatologist, paediatric surgeon and, especially, an experienced pathologist will be required in addition to those of the radiologist.

Topics: Anal Canal; Contrast Media; Enterocolitis, Pseudomembranous; Hirschsprung Disease; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Obstruction; Intestine, Small; Meconium; Prospective Studies; Radiography, Abdominal; Rectum; Retrospective Studies

Taking the necessary precautions essential for accurate trace element analysis, the zinc concentrations of 227 samples of amniotic fluid taken at term were determined by means of neutron activation analysis. Half of the zinc was found to be bound to the particles present in amniotic fluid. In the control group (123 cases) the zinc concentrations ranged from 25-261 micrograms/l for untreated samples and from 14-143 micrograms/l when the samples were centrifuged for 10 min at 22 000 g prior to analysis. The values showed log-normal frequency distributions and were lower than any of the values published in the literature to date. No statistically significant difference could be found, when zinc concentrations of various risk groups (mothers suffering from gestosis or diabetes mellitus, newborns hypo- or hypertrophic, twin births) were compared with the zinc concentration of the control group. The amniotic fluid zinc concentration is not, therefore, a suitable indicator for the diagnosis of disturbances of the embryonic development.

Topics: Amniotic Fluid; Female; Fetal Blood; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Neutron Activation Analysis; Pregnancy; Pregnancy Complications; Pregnancy in Diabetics; Prenatal Diagnosis; Quality Control; Zinc

In 20 years the authors have met with 115 cases of meconium peritonitis (MP). The high incidence in China is shown. In all cases there were intraabdominal calcifications. There were no cases of fibrocystic disease. The authors classify 3 types: 1. Neonatal obstructive type 41 cases. 2. Free perforation with: Free pneumoperitoneum 15 cases. Localized pneumoperitoneum 23 cases. 3. No signs or symptoms, with potential intestinal obstruction 23 cases. The series shows a low incidence of atresia. The authors suggest necrotizing enterocolitis as a cause because of the high incidence of stenosis. Three prenatally diagnosed cases are discussed. All had hydramnios and fetal abdominal calcifications. Two of these were confirmed after birth. The mortality is high (42.6%). Abdominal x-ray in all cases with polyhydramnios may lead to a positive diagnosis of MP.

Topics: Abdomen; Adult; Calcinosis; China; Enterocolitis, Pseudomembranous; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Perforation; Meconium; Peritonitis; Pneumoperitoneum; Polyhydramnios; Pregnancy; Prenatal Diagnosis

Topics: Cysts; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Peritonitis

Topics: Gastrointestinal Hemorrhage; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Pneumonia, Aspiration; Tolazoline

Topics: Child; Chlorides; Cholestasis, Intrahepatic; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Peritonitis; Sweat; Syndrome

Topics: Apgar Score; Body Temperature Regulation; Cardiovascular Physiological Phenomena; Drug Therapy; Fetus; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Pneumonia, Aspiration; Respiratory Physiological Phenomena; Resuscitation; Shock

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Perforation; Male; Meconium; Spectrophotometry

Serial measurements of pulmonary function and arterial blood gases during the first 3 postnatal days of life were obtained in 12 infants with meconium aspiration syndrome (MAS). Nine normal neonates with similar weight and gestational age were studied as controls. Infants with MAS has significantly lower pH on day 1, and had greater P(A-a)O2 throughout the study period than that of normal controls. The PCO2 was comparable between the groups. Both dynamic lung compliance (Cdyn) and specific lung compliance (C/VL) were lower in infants with MAS as compared with those of normal infants. The functional residual capacity (FRC) for normal infants on days 1, 2, and 3 were 2.0 +/- 0.3, 2.1 +/- 0.3, and 2.2 +/- 0.3 ml/cm, respectively, and for infants with MAS were 1.8 +/- 0.4, 2.3 +!- 1.1, and 2.2 +/- 0.6 ml/cm, respectively. Radiographic hyperinflation of the lungs was seen in 6 infants with MAS on day 1; 3 were associated with high FRC (greater than 2 SD of normal) and 2 with low FRC, indicating air trapping. The early use of PEEP should be cautious if hyperinflation or air trapping is present.

Topics: Blood Gas Analysis; Humans; Infant, Newborn; Infant, Newborn, Diseases; Lung Compliance; Lung Volume Measurements; Meconium; Pneumonia, Aspiration

Topics: Cystic Fibrosis; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium

The authors propose a simple, quick and reliable biochemical method for diagnosis of amniotic aspiration in the newborn infant. The optical density of the infant's first urine is determined at 420, 390 and 405 nm. A urinary meconial index (IMU) is computed from these values. A meconial amniotic inhalation must be suspected if this index is greater than one. The presence of coproporphyrins identified in urine of infants having inhaled meconial amniotic fluid seems to be at the origin of the spectral characteristics of pathological urines.

Topics: Amniotic Fluid; Coproporphyrins; Densitometry; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Methods; Pneumonia, Aspiration

Meconium diseases in infancy cannot be neatly separated into discrete categories of meconium plug syndrome, meconium ileus, and meconium peritonitis; nor can the therapy of each condition. A patient with any of the three may or may not have cystic fibrosis. All babies with any form of meconium obstruction or atresia must have a sweat chloride test to confirm or rule out this diagnosis. Repeated gastrografin enemas can decrease the need for operative intervention in all babies with meconium plug syndrome and in selected babies with meconium ileus. Babies with meconium diseases can now be managed with a low perinatal mortality.

Topics: Barium Sulfate; Cystic Fibrosis; Female; Hirschsprung Disease; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Intestinal Obstruction; Male; Meconium; Peritonitis; Retrospective Studies

Topics: Abscess; Animals; Calcinosis; Cystic Fibrosis; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Peritoneal Diseases; Peritonitis; Radiography; Rats

Topics: Cystic Fibrosis; Enema; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium; Postoperative Complications; Pregnancy

Topics: Diatrizoate; Diatrizoate Meglumine; Enema; Enterocolitis, Pseudomembranous; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Topics: Calcinosis; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Peritonitis; Radiography

Topics: Female; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Orchitis; Peritonitis; Pregnancy

A recurrence rate for meconium ileus of 39% was found among C.F. affected siblings in a study of 488 families with at least one C.F. child born over a 24 year period. The recurrence rate was highly significant and indicated a familial trend for the occurrence of meconium ileus. The findings of the study support the existence of genetic heterogeneity in cystic fibrosis.

Topics: Cystic Fibrosis; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

There are many treatment modalities for uncomplicated meconium ileus. However, for neonates with intestinal obstruction unrelieved by nonoperative measures we advocate T-tube ileostomy with postoperative irrigation of the intestine utilizing pancreatic enzyme. Our series includes 11 infants with uncomplicated meconium ileus who underwent T-tube ileostomy 24--96 hr after birth. Of the 7 females and 4 males only 2 infants failed to pass meconium. One infant required reexploration for persistent obstruction and 1 infant, the only death encountered, had overwhelming pulmonary infection and intracranial hemorrhage. The remaining 9 infants passed meconium between the 1st and 11th postop days. The T-tube was removed by pulling it out between the 10th and the 14th postop day with the T-tube tract closing spontaneously in all patients. Our experience with T-tube ileostomy suggests that resection of dilated but viable ileum is not necessary for prompt intestinal function in the neonate. With the use of pancreatic enzyme irrigation, the tenacious meconium in these patients can be rapidly liquified and expelled per rectum or T-tube and the necessity of mechanical removal during the operative procedure avoided.

Topics: Catheterization; Female; Humans; Ileostomy; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium

Meconium peritonitis occasionally occurs as a localized collection of meconium contained in a cyst made of fibrous granulation tissue. The cyst may contain only meconium or also encase loops of bowel. One such case is reported.

Topics: Cysts; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis; Radiography

Meconium Ileus Equivalent is a condition which occurs in patients with cystic fibrosis where the ileum becomes obstructed by bowel content of abnormal consistency. Intercurrent chest infection or absence of pancreatic extract supplements are often the exacerbating cause. Plain films of the abdomen show small bowel obstruction and in some a nodular pattern in the small bowel, the nodules being larger than those seen in quiescent cystic fibrosis. Gastrografin enemas and/or enemas with acetyl cysteine can be used in the treatment of the condition, the Gastrografin having the advantage of confirming the diagnosis radiologically. The condition is important as it can be the presenting feature of cystic fibrosis in childhood and even in early adult life, and the operative mortality and morbidity are high. Conservative treatment should be pursued vigorously and operation only undertaken if unavoidable.

Topics: Child; Child, Preschool; Cystic Fibrosis; Humans; Ileum; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Radiography

Two neonates with clinical features of meconium plug syndrome (MPS) were found to have ileocolic intussusception associated with meconium plugs inspissated in the distal ileum. Hydrostatic reduction of the intussusception relieved the intestinal obstruction. Cystic fibrosis was excluded by sweat test and follow-up.

Topics: Female; Humans; Ileal Diseases; Infant, Newborn; Infant, Newborn, Diseases; Intussusception; Meconium; Radiography; Syndrome

Topics: Esophageal Atresia; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Peritonitis

Topics: Adult; Female; Humans; India; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Pneumonia, Aspiration; Pregnancy; Respiratory Distress Syndrome, Newborn; Retrospective Studies

To compare the efficacy of bulb and catheter suctioning of upper airway meconium in neonates, meconium labeled with technetium Tc 99m sulfur colloid was injected into the trachea and oropharynx of anesthetized kittens. Human birth conditions were simulated by an inflated blood pressure cuff around the thorax and abdomen of the animals and by partial degassing of the lungs before introduction of meconium. Distribution of meconium in the upper airway was determined by scintigraph. Catheter suction brought about a 43% decrease in radioactivity while there was only a 1% decrease after bulb suctioning. Meconium may persist in the trachea for more than 20 minutes after introduction, indicating the desirability of continued suctioning efforts in neonates with meconium aspiration syndrome. The relative safety of the two techniques was not assessed.

Topics: Airway Obstruction; Animals; Catheterization; Cats; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Pneumonia, Aspiration; Suction; Syndrome

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Perforation; Male; Meconium; Peritonitis; Sigmoid Diseases

Topics: Apgar Score; Body Temperature Regulation; Cardiovascular Physiological Phenomena; Female; Fetus; Humans; Hypotension; Infant, Newborn; Infant, Newborn, Diseases; Lung; Meconium; Pregnancy; Resuscitation

Chest physical therapy for neonates with pulmonary dysfunction is a growing specialty of physical therapy practice. The purpose of this article is to provide physical therapists current information regarding chest physical therapy for the newborn infant. The neonatal diagnoses for which chest physical therapy is useful or has good rationale are discussed. Common complications are reviewed that affect physical therapy and medical treatment for infants with respiratory diseases and prematurity. Specific indications, contraindications, and precautions for physical therapy techniques are listed. Chest physical therapy evaluation and treatment are described and rationale for the application of various techniques is provided. Literature is reviewed dealing with the effects of chest physical therapy on neonates with pulmonary dysfunction. The strengths and weaknesses of each reviewed study are analyzed and suggestions for direction of future research for physical therapists are provided.

Topics: Adult; Bronchopulmonary Dysplasia; Child; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Percussion; Physical Therapy Modalities; Pneumonia; Posture; Respiratory Distress Syndrome, Newborn; Respiratory Tract Diseases

An evaluation of patients with meconium peritonitis shows that, apart from the fibro-adhesive type, the (Pseudo) cystic and the generalized type, a fourth type can be distinguished. In a case of this fourth type, the "microscopic" type of meconium peritonitis, no signs of a peritonitis are found on macroscopic examination of the abdominal cavity. Conversely, microscopic examination will reveal meconium components focally outside the bowel. The clinical and histological data of 14 patients are discussed. It is pointed out that a significantly large number of patients with meconium peritonitis also have atresia of the small bowel. Based on the patient evaluation, a hypothesis is brought forward concerning the pathogenesis of these atresias.

Topics: Female; Humans; Ileum; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Jejunum; Male; Meconium; Peritonitis

Topics: Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Perforation; Male; Meconium; Peritonitis

Topics: Asphyxia Neonatorum; Humans; Infant, Newborn; Infant, Newborn, Diseases; Leukocyte Count; Meconium; Pneumonia, Aspiration

Topics: Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Pneumonia, Aspiration; Pregnancy; Syndrome

Severe hypoxia unresponsive to maximum ventilatory support occurs both in idiopathic respiratory distress syndrome and meconium aspiration. We recently encountered a 980 g female infant with respiratory distress syndrome and 3 300 g female infant with meconium aspiration and persistant fetal circulation whose clinical course necessitated the use of tolazoline and dopamine to reduce pulmonary and to stabilize systemic pressures. The infant with respiratory distress syndrome responded with a PaO2 increase of 2.7 kPa while the infant with persistant fetal circulation and meconium aspiration showed a 51.6 kPa rise. Combined pharmacologic therapy may have a role in improving oxygenation status in severely hypoxemic infants receiving maximum support.

Topics: Dopamine; Female; Humans; Hypoxia; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Lung; Meconium; Pneumonia, Aspiration; Respiratory Distress Syndrome, Newborn; Tolazoline; Vascular Resistance; Vasoconstriction

Topics: Aging; Bronchial Diseases; Bronchodilator Agents; Child, Preschool; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Respiratory Tract Diseases; Syndrome

Topics: Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Peritonitis; Radiography

Sixteen neonatal patients diagnosed as having the meconium aspiration syndrome were selected for management with extracorporeal circulation with a membrane oxygenator (ECMO) with 8 survivors over 4 yr. All patients weighed greater than 2 kg. Each was placed in the 100% mortality group according to a Neonatal Pulmonary Insufficiency Index (NPII) based on hourly pH and FiO2 determinations. The typical patient course on ECMO was stabilization for the first 12 hr then improvement on high bypass flow rates for 12-24 hr to maintain a pAO2 for 50-60 mm Hg with minimal ventilator settings with an FiO2 of 0.3-0.4. Bypass flow rates were reduced to maintain adequate pAO2 with similar ventilator settings for another 24 hr. Survivors were taken off bypass and decannulated while on similar ventilator settings. Nonsurvivors did stabilize or improve but usually exhibited symptoms of intracranial hemorrhage by 48 hr. Intracranial hemorrhage appeared to be related to the degree of prebypass acidosis. Successful ECMO support reduced the expected mortality from severe meconium aspiration from 100% to 50%. Early institution of ECMO, before acidosis worsens, seems to be indicated to reduce the morbidity of conventional ventilator management and to prevent intracranial hemorrhage from severe prebypass acidosis. Long term followup indicates that these patients have progressed satisfactorily according to developmental testing for as long as 4 yr.

Topics: Catheterization; Extracorporeal Circulation; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Pneumonia, Aspiration; Respiratory Insufficiency

Topics: Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Pneumonia, Aspiration; Pregnancy

Topics: Calculi; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Diseases; Male; Meconium

Topics: Cystic Fibrosis; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Megacolon; Syndrome

The bacteriology of tracheal aspirates from 28 intubated newborn babies was studied. There was no correlation between such colonization and the respiratory distress syndrome. Endotracheal suction of intubated infants did provide a reliable specimen source for determining the etiology of perinatal pneumonia. Presence of polymorphonuclear leukocytes in the aspirate correlated well with infection. Anaerobic bacteria were found to play a role in three of the five cases of pneumonia.

Topics: Bacteria; Critical Care; Exudates and Transudates; Female; Humans; Infant Care; Infant, Newborn; Infant, Newborn, Diseases; Intubation, Intratracheal; Male; Meconium; Pneumonia; Pneumonia, Aspiration; Respiratory Distress Syndrome, Newborn; Trachea

Topics: Cystic Fibrosis; Diatrizoate; Diatrizoate Meglumine; Enema; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestine, Small; Meconium

Topics: Cystic Fibrosis; Humans; Ileal Diseases; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Topics: ABO Blood-Group System; Asphyxia Neonatorum; Blood Group Incompatibility; Family Practice; Humans; Hypoglycemia; Infant, Newborn; Infant, Newborn, Diseases; Infant, Small for Gestational Age; Internship and Residency; Meconium; Nurseries, Hospital; Pneumothorax; Risk; Vitamin K Deficiency Bleeding

Serial human placental lactogen (hPL) determinations were performed on 806 women with normal and abnormal pregnancies late in the pregnancy. These results were not reported to the clinicians involved. For the study population as a whole, low hPL levels did not effectively predict those adverse perinatal outcome variables evaluated. Further analysis revealed that this was true both for the normal and abnormal pregnancy groups. Our data do not support the routine use of antepartum hPL screening, as advocated by others, as a means of improving perinatal outcome. In certain at-risk patients, there was an association between low hPL values and the presence of 1 or more of the adverse outcome variables. However, these patients had been recognized clinically as having fetuses in jeopardy.

Topics: Female; Fetal Death; Fetal Growth Retardation; Humans; Infant Mortality; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Placental Lactogen; Pregnancy; Pregnancy Complications; Prenatal Diagnosis; Risk

Topics: Enterobacter; Enterobacteriaceae; Enterobacteriaceae Infections; Feces; Female; Humans; Infant; Infant Nutritional Physiological Phenomena; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium

Topics: Blood Viscosity; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium; Polycythemia

Thirty-nine critically ill infants with pulmonary disease received tolazoline because of severe hypoxemia refractory to administration of 100% O2 and mechanical ventilation. Twenty-seven (69%) of the infants responded with an increase in PaO2 greater than or equal to 20 torr in the first umbilical arterial gas after completion of the initial ten-minute infusion (1 to 2 mg/kg) of the drug. A response was not correlated with survival. The overall survival was 46%, essentially unchanged from our previous report (44%). Infants with hyaline membrane disease had the poorest survival rate (33%). Complications associated with the use of tolazoline occurred in 82% of the infants. A hypotensive reaction, defined as a 25% decrease in mean arterial pressure from the pre-tolazoline level, occurred in 67% of the infants, and more commonly in the infants with RDS (87%). In 11 infants who did not respond to the initial dose of tolazoline, the dose was increased up to 10 mg/kg/hour; only one infant responded, and eight (73%) had a hypotensive reaction.

Topics: Carbon Dioxide; Humans; Hyaline Membrane Disease; Hypoxia; Infant, Newborn; Infant, Newborn, Diseases; Inhalation; Lung Diseases; Meconium; Oxygen; Oxygen Inhalation Therapy; Respiration, Artificial; Respiratory Distress Syndrome, Newborn; Syndrome; Tolazoline; Umbilical Arteries

Topics: Asphyxia Neonatorum; Female; Gestational Age; Humans; Hyaline Membrane Disease; Infant, Low Birth Weight; Infant, Newborn; Infant, Newborn, Diseases; Male; Massachusetts; Meconium; Mediastinal Emphysema; Pneumonia, Aspiration; Pneumopericardium; Pneumothorax; Pulmonary Emphysema; Respiration, Artificial; Respiratory Function Tests; Retrospective Studies

Topics: Humans; Ileal Diseases; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Perforation; Male; Meconium; Peritonitis; Prognosis; Radiography

1. The mucus glycoproteins in meconium from normal infants and from infants having cystic fibrosis with meconium ileus have been studied. 2. Whereas normal meconium contained about 50% protein-bound carbohydrate, the meconium from cystic fibrosis contained only about 10%. 3. Glycopolypeptides were prepared from the mucus of glycoproteins. The oligosaccharide units from this material were released and fractionated. The fractions ranged widely in size and composition. 4. The fractions from cystic fibrosis specimens had a significantly higher content of fucose than those from normal specimens.

Topics: Carbohydrate Metabolism; Cystic Fibrosis; Fucose; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Monosaccharides; Mucoproteins; Oligosaccharides

Topics: Germany, West; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Intestinal Obstruction; Meconium; Postoperative Complications

During the 14 yr from 1965 through 1978, 49 infants presented shortly after birth with intestinal obstruction due to impacted meconium. Three of these patients did not have fibrocystic disease. Eight patients were cured by a Gastrografin enema. There were 18 patients who had complications that included associated atresia, volvulus, and/or peritonitis. Various operations were done including resection with either primary anastomosis or enterostomy or varieties of the foregoing. Twenty-three babies had the simple uncomplicated form of meconium ileus. Eleven of these underwent resection and six patients died. Twelve patients were treated by laparotomy, ileotomy through a purse-string suture and prolonged irrigations using acetylcysteine. Of this group only one succumbed. This latter course of management is recommended for patients with simple uncomplicated meconium ileus as it involves no resection, no enterostomy, nor any primary anastomosis.

Topics: Cystic Fibrosis; Female; Humans; Ileostomy; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Laparotomy; Male; Meconium; Methods

Although NSLCS has been considered to have a benign course, we have described an infant who had intrauterine intestinal perforation and meconium peritonitis associated with the NSLCS. Infants of diabetic mothers who are stillborn or who develop abdominal distention shortly after delivery should be suspected of having this complication of NSLCS. This disorder must also be considered in the differential diagnosis of infants who present with meconium peritonitis.

Topics: Colonic Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Perforation; Meconium; Peritonitis; Syndrome

Topics: Albumins; Cystic Fibrosis; Finland; Humans; Infant, Newborn; Infant, Newborn, Diseases; Mass Screening; Meconium

Screening for cystic fibrosis (CF) in newborns is desirable, and efforts should continue in establishing a system of easily available, reliable, simple, and inexpensive tests. In addition to the Boehringer-Mannheim (BM) test for the detection of albumin, we propose the assay for lactase and beta-D-fucosidase in meconium. These latter two enzymes are present in the meconium of babies with CF and absent in meconium of most healthy babies. In a mass screening program for CF involving 20,182 specimens of meconium using only the BM strip, we found 46 positive results. Twenty-nine specimens came from infants with CF, six of whom had meconium ileus. Seventeen specimens yielded false-positive results by the BM test. Eleven of these would have been excluded by the addition of the lactase and beta-D-fucoside assay, thus reducing the false-positive test results by nearly 61%. In a comparative study of the three methods, the lactase and beta-D-fucosidase yielded 1.2% false-positives when examined independently. Performance of these two assays may allow greater specificity in diagnosis when used in addition to the BM test.

Topics: Albumins; alpha-L-Fucosidase; beta-Galactosidase; False Positive Reactions; Galactosidases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Mass Screening; Meconium; Sweat

Topics: Adult; Airway Obstruction; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Pneumonia, Aspiration; Pregnancy

Although successful treatment of meconium ileus with Gastrografin enema has been attributed to the hypertonicity of this material, Tween 80, present in a 0.75% concentration, may be its most effective component. Tween 80 acts as a surface-active substance and stool emulsifier. An enema solution of 1%-2% Tween 80 and isotonic sodium diatrizoate has been effective in the relief of meconium or fecal mass obstruction in infants and children.

Topics: Adolescent; Child, Preschool; Diatrizoate; Enema; Fecal Impaction; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium; Polyethylene Glycols; Polysorbates

The meconium plug syndrome (MPS) is a common cause of low intestinal obstruction in newborn infants. Usually, it is benign and not associated with other intestinal dysfunction. We describe the cases of three infants in whom there was intestinal obstruction consistent with the MPS and in which cystic fibrosis (CF) was later documented. We suggest that there is an association between the MPS and CF, and that the condition of all infants with the MPS be evaluated for the possibility of both Hirschsprung's disease and CF.

Topics: Cystic Fibrosis; Diagnosis, Differential; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium; Megacolon; Radiography; Syndrome

The first urine passed by a newborn infant who has inhaled meconium or meconium-stained amniotic fluid often contains a dark-coloured water-soluble substance, recognisable spectrophotometrically by an absorption band at about 405 nm. Spectrophotometric analysis of the first urine can in this way be used to diagnose preceding meconium aspiration.

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Inhalation; Light; Meconium; Respiration; Spectrophotometry; Urine

Topics: Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Inhalation; Meconium; Suction; Syndrome

Topics: Genital Diseases, Male; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Peritonitis; Scrotum

Topics: Enema; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Ischemia; Meconium; Peritonitis; Radiography; Rupture, Spontaneous; Stomach; Stomach Rupture

Topics: Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Pneumonia, Aspiration; Syndrome

The clinical course and follow-up of 14 neonates who developed acute renal failure are reported. Renal failure in these patients was secondary to major perinatal disorders, e.g., hyaline membrane disease, pneumonia, hemorrhage, or sepsis. Thirteen patients had hypoxia and nine were in shock when renal failure developed. Five patients died during the acute stage of renal failure. Of nine survivors, five patients sustained residual renal damage.

Topics: Acute Kidney Injury; Anuria; Follow-Up Studies; Humans; Hyaline Membrane Disease; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Pneumonia; Shock

Topics: Albumins; Cystic Fibrosis; Humans; Infant, Newborn; Infant, Newborn, Diseases; Mass Screening; Meconium

The milk curd syndrome is an as yet little known cause of intestinal obstruction in neonates. Two personal cases are reported, and 37 others are collected from the world literature. Infants with milk curd syndrome have a normal discharge of meconium. The intestinal obstruction appears usually between the 2nd and 16th day after birth. In most of the cases, the milk curd was found in the distal part of the ileum. The aetiology of the milk curd obstruction syndrome remains still unclear. The composition of artificial milk feeding formula in connexion with transitory absorption deficiency of amino acids, and the possibility of a temporarily insufficient excretion of bile acids are discussed.

Topics: Female; Humans; Infant Nutritional Physiological Phenomena; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Milk, Human; Syndrome

Topics: Cystic Fibrosis; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Prognosis

Topics: Cystic Fibrosis; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Mass Screening; Meconium; Melena

One hundred four postdate pregnancies were managed according to a well-defined protocol calling for weekly oxytocin challenge tests and urinary estriols three times per week. Although the perinatal mortality rate in these patients was not increased there was a significant increase in the incidence of neonatal morbidity and complications. The clinical syndrome of dysmaturity was seen in 20 per cent of the neonates. When meconium was present in the amniotic fluid the incidence of neonatal and fetal complications was higher. The cesarean section rate was twice the normal rate, with nonprogression of labor being the commonest indication. It is recommended that: (1) pregnancies carried beyond 42 weeks do not require termination simply because they are post dates; (2) all postdate patients should be monitored during labor; (3) trained personnel to initiate neonatal resuscitation should be present at each postdate delivery.

Topics: Amniocentesis; Cesarean Section; Estriol; Female; Fetal Death; Fetal Heart; Fetal Monitoring; Heart Rate; Humans; Infant Mortality; Infant, Newborn; Infant, Newborn, Diseases; Labor, Obstetric; Meconium; Oxytocin; Placenta Diseases; Pregnancy; Pregnancy, Prolonged; Risk

The significance of MSAL as a sign of fetal distress is controversial. To better assess this condition, we present a classification of MSAL based on the timing and quantity of meconium passed and divided into early light, early heavy, and late passage of MSAL. By means of this classification with a problem-oriented risk assessment system, 2,933 pregnancies were prospectively evaluated during labor. The incidence of meconium passage was 22 per cent, of which early light constituted 53.6 per cent, early heavy 25.2 per cent, and late passage 21.2 per cent. Early heavy MSAL is associated with increased fetal and neonatal morbidity and death, and with a number of antecedent obstetric problems. Late passage of MSAL encountered no perinatal losses, but is associated with increased neonatal morbidity occurring late in labor. Early light MSAL, constituting over half of all our meconium group of patients, is not associated with any increased intrapartum or neonatal morbidity or death. This classification of MSAL is an effective tool for risk assessment during labor.

Topics: Amniotic Fluid; Birth Weight; Classification; Delivery, Obstetric; Female; Fetal Death; Fetal Diseases; Gestational Age; Humans; Infant Mortality; Infant, Newborn; Infant, Newborn, Diseases; Inhalation; Labor, Obstetric; Meconium; Pregnancy; Prospective Studies; Risk; Syndrome; Time Factors

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Inhalation; Meconium; Respiration; Tolazoline

Six neonates are described in whom plain films of the abdomen demonstrated scattered flecks of calcification. Three of the patients had rectal atresia with recto-urethral fistula, one rectal atresia without fistula, one jejunal atresia and one a severe stenosis of the distal small bowel associated with log segment aganglionosis. At operation the calcification was found to be in meconium within the bowel lumen and not as expected to represent serosal plaques following meconium peritonitis due to an intrauterine bowel perforation. Previous case reports are reviewed and possible mechanism discussed.

Topics: Calcinosis; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Obstruction; Male; Meconium; Radiography

Two newborns with intestinal obstruction of the terminal ileum without mucoviscidosis were cured by Gastrografin enema. A further case of a premature infant showed, at autopsy, a large intestine containing normal meconium, but an ileum which was plugged with tenacious meconium containing PAS-positive and alcian blue-negative mucus. Our 3 cases were similar to cases of "meconium disease" reported by Rickham and of "meconium plug in the small intestine" reported by Emery. The primary cause of this disease lies in the large amount of PAS-positive mucus secreted from goblet cells of the ileal mucosa and the hypertrophy of lymph nodules in the ileal submucosa.

Topics: Contrast Media; Cystic Fibrosis; Enema; Female; Humans; Hypertonic Solutions; Hypertrophy; Ileum; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Mucosa; Intestinal Obstruction; Male; Meconium; Mucus

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Perforation; Meconium; Peritonitis

Topics: Adult; Female; Humans; Ileum; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Male; Meconium; Peritonitis; Pregnancy; Radiography

The intracranial pressure was monitored via the anterior fontanel, using a noninvasive technique, in 78 acutely ill, 39 normal term, and 6 normal preterm infants. In normal term and preterm infants the anterior fontanel pressure (AFP) was 10.2 +/- 0.4 and 9.5 +/- 0.8 cm H2O, respectively. Infants with hyaline membrane disease had elevated pressure (13.3 +/- 0.6 cm H2O), which was higher than that of normal preterm infants. Following an episode of intracranial hemorrhage in four infants, the AFP increased to 26.2 +/- 2.5 cm H2O. Elevated pressure was noted in infants with meconium aspiration syndrome (24.1 +/- 1.8 cm H2O); the pressure decreased during the phase of recovery (15.6 +/- 3.5 cm H2O). Elevated pressure was noted in infants with meningitis and hydrocephalus. Repeated measurements helped to diagnose shunt obstruction in an infant with hydrocephalus.

Topics: Cerebral Hemorrhage; Cerebrospinal Fluid Shunts; Humans; Hyaline Membrane Disease; Hydrocephalus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Inhalation; Intracranial Pressure; Meconium; Meningitis; Monitoring, Physiologic; Syndrome

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Inhalation; Meconium; Respiration; Respiratory Insufficiency

Topics: Cystic Fibrosis; False Positive Reactions; Glycerol; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Suppositories

Topics: Airway Obstruction; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Suction; Trachea

Hypoxia in newborn infants is becoming much easier to prevent, detect and treat. Nevertheless the successful management of potentially hypoxic fetuses and newborn infants remains the major challenge to all physicians concerned with perinatal care. What is at stake is not only that sick infants should survive, but equally or more importantly that the survivors should be normal children. Recent follow-up studies show that this aim can, with few exceptions, now be achieved (Stewart and Reynolds, 1974; Davies and Stewart, 1975; Durbin et al, 1976).

Topics: Apnea; Asphyxia Neonatorum; Blood Circulation; Humans; Hyaline Membrane Disease; Hypoxia; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Lung Diseases; Meconium; Pneumothorax; Pulmonary Edema; Pulmonary Surfactants; Respiration; Vitamin K Deficiency Bleeding

The results of an evaluation over 4 years (1973-1976) of 16,620 BM-tests (Boehringer-Mannheim newborn screening for cystic fibrosis) at 8 hospitals in Switzerland are presented and the data from analysis of albumin, protein and alpha1-antitrypsin concentrations, and on trypsin-inhibitory capacity of the meconia are discussed. 99.5% of the tests were negative. Of the remaining 0.5% BM-positive tests, the diagnosis of cystic fibrosis required confirmation by sweat test and clinical course in 6 cases, or 0.04% of the total collective. The test was false-negative in 2 cases (0.012%), of which one had a primary pulmonary form of cystic fibrosis. The study shows that the BM-test, as screening test for cystic fibrosis, makes it possible to distinguish between "normal" and "suspect". By calculating the ratio albumin to alpha1-antitrypsin, it would be possible to verify the probability of a reliable diagnosis as early as a few days after birth. As before, however, it would be indispensable to confirm the diagnosis of cystic fibrosis by a sweat test with pilocarpin iontophoresis. By consistent screening in all obstetric and pediatric clinics it would be possible to improve early diagnosis still further.

Topics: alpha 1-Antitrypsin; Cystic Fibrosis; False Negative Reactions; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Mass Screening; Meconium; Switzerland; Time Factors; Trypsin Inhibitors

Meconium aspiration syndrome is a perinatal problem which requires the full cooperation and coordination of obstetrical and pediatric personnel if it is to be avoided. Prompt, efficient delivery room management can minimize the sequelae of aspirated meconium. However, those infants who develop severe meconium aspiration syndrome are best managed in neonatal intensive care units where they can be closely monitored and vigorously treated.

Topics: Amniotic Fluid; Animals; Fetus; Humans; Infant, Newborn; Infant, Newborn, Diseases; Inhalation; Meconium; Positive-Pressure Respiration; Radiography; Respiration; Respiratory Insufficiency; Sheep; Suction; Syndrome; Trachea

Effective resuscitation of the newborn requires knowledge of the cause of depression. Four major causes are trauma, asphyxia, medication, and malformation. More than one of these may contribute to depression in a single infant. The first principles of resuscitation are to avoid cooling the infant and to establish an airway. Infants with an Apgar score of 3 to 4 at one minute usually need bag-and-mask ventilation, while those with scores of 0 to 2 require immediate ventilation, preferably by means of endotracheal intubation. Severely depressed infants may also require chemical resuscitation and closed cardiac massage. Fetal depression caused by narcotic analgesics given to the mother can be reversed with the use of naloxone hydrochloride (Narcan). Infants asphyxiated on the basis of malformations may benefit from expeditious diagnostic and therapeutic procedures performed in the delivery room.

Topics: Apnea; Asphyxia Neonatorum; Congenital Abnormalities; Delivery, Obstetric; Female; Fetus; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intubation, Intratracheal; Maternal-Fetal Exchange; Meconium; Pregnancy; Resuscitation; Suction; Wounds and Injuries

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Perforation; Male; Meconium; Peritonitis; Radiography

Neonatal small left colon syndrome is a functional disease of the lower colon which produces typical signs and symptoms of intestinal obstruction. It is manifest in the first 24-48 hours of life, particularly in infants of diabetic mothers and, if detected early, it can be fully cured by radiographic contrast enemas, not unlike meconium plug syndrome. Intestinal perforation and death may occur, however. The etiology of the disease is unknown but it may relate to neurohumoral imbalances between the autonomic nervous system and glucagon.

Topics: Colonic Diseases; Contrast Media; Enema; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Pregnancy; Pregnancy in Diabetics; Solubility; Syndrome; Water

Topics: Asphyxia; Asphyxia Neonatorum; Blood Glucose; Blood Viscosity; Brain Diseases; Female; Fetal Diseases; Fetal Growth Retardation; Humans; Hypocalcemia; Hypoglycemia; Infant, Newborn; Infant, Newborn, Diseases; Inhalation; Kidney Diseases; Meconium; Polycythemia; Pregnancy; Prognosis; Syndrome

Six patients with meconium ileus, in whom bowel resection and end-to-end anastomosis were performed, are presented. Meconium ileus may be simple or complicated. The simple form may be treated by Gastrografin enema. Surgery is indicated if conservative treatment fails and for patients with a complicated obstruction. Provided the bowel is disobstructed and carefully resected, end-to-end anastomosis is preferable. Confirmation of the diagnosis by careful histological examination of the resected bowel is urged.

Topics: Cystic Fibrosis; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Suction

Topics: Cystic Fibrosis; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Sweat

Apparently spontaneous neonatal intestinal perforation may be difficult to diagnose if the condition is not kept in mind. It may present with free perforation or with the late effects of meconium peritonitis. Five cases are described. There is a high mortality associated with bacterial peritonitis, and the importance of early diagnosis and energetic resuscitation is underlined.

Topics: Colonic Diseases; Female; Humans; Ileum; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Perforation; Jejunum; Male; Meconium; Peritonitis; Rupture, Spontaneous; Stomach Rupture

Seventy five pregnancies where the presence of antepartum meconium was detected by transabdominal amniocentesis, were compared with 224 cases showing clear amniotic fluid (A.F.). The statistical differences were analized in terms of data of anamnesis, diseases complicating pregnancy, gestational age, fetal maturity diagnosis from the A.F. study, oxytocin test, labor characteristics, perinatal mortality and neurologic morbidity during the first nine months of life. The results suggest that the presence of antepartum meconium implies an increase in fetal risk, demanding an adequate analysis of the obstetric solutions, which is discussed.

Topics: Adult; Amniotic Fluid; Apgar Score; Female; Fetal Distress; Follow-Up Studies; Humans; Infant, Newborn; Infant, Newborn, Diseases; Labor, Obstetric; Meconium; Menstruation; Nervous System Diseases; Obstetric Labor Complications; Parity; Pregnancy; Pregnancy Complications; Pregnancy, Prolonged; Prognosis

Neonatal small left colon syndrome is a cause of functional colon obstruction in newborn infants, with a high association of maternal diabetes. There has been much confusion regarding its relationship to meconium plug syndrome and aganglionosis. Six cases of aganglionosis (2 in infants of diabetic mothers) were encountered in which the radiographic findings were identical to small left colon syndrome, indicating the need for caution in dismissing aganglionosis solely on the basis of a small left colon seen radiographically in a newborn infant with colon obstruction. Small left colon and meconium plug syndrome are overlapping entities in the total spectrum of functional intestinal obstruction in newborn infants.

Topics: Adolescent; Adult; Colon; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium; Megacolon; Pregnancy; Pregnancy in Diabetics; Radiography; Syndrome

Meconium ileus is in most cases difficult to diagnose preoperatively; however, aganglionosis should be excluded in every case (rectal double-suction biopsy, manometry). In cases of uncomplicated meconium ileus (no perforation, no further intestinal obstructions) lysis of the meconium by a Gastrografin enema is tried first. In case of no relief, an intraoperative puncture of the bowel and Gastrografin instillation is performed. If there is no relief a small bowel resection is performed and a Bishop-Koop anastomosis or a chimney anastomosis established. A distinction must be made between meconium ileus, meconium disease, meconium plug syndrome, and curd obstruction. Results show a survival rate of 80%.

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Methods

Topics: Adult; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium; Radiography; Syndrome

Topics: Albumins; Cystic Fibrosis; False Positive Reactions; Humans; Infant, Newborn; Infant, Newborn, Diseases; Lactose; Meconium; Proteins; Sweat

Topics: Albumins; Animals; Cystic Fibrosis; Female; Fetal Diseases; Genetic Counseling; Heterozygote; Homozygote; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Pregnancy; Prenatal Diagnosis; Rats

A controlled study for the management of antepartum meconium-stained amniotic fluid (MSAF) detected by amnioscopy performed in a total of 508 patients is presented. The incidence of antepartum MSAF was 2.2%, while intrapartum MSAF was found in 15% of cases. A significant incidence of depressed neonates was found in the latter group. Patients with antepartum MSAF had no perinatal losses, whether managed expectantly or by oxytocin induction. Immediate operative intervention (ie, cesarean section) is not warranted. Observations on FHR patterns, fetal pH, and Apgar scores of these patients are presented.

Topics: Apgar Score; Estriol; Female; Fetal Death; Fetal Distress; Fetal Heart; Fetoscopy; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Pregnancy; Pregnancy Complications; Prenatal Care; Prenatal Diagnosis

Topics: Albumins; Chlorides; Cystic Fibrosis; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Nails; Prognosis; Sodium; Sweat

Topics: Albumins; Clinical Enzyme Tests; Cystic Fibrosis; Humans; Infant, Newborn; Infant, Newborn, Diseases; Mass Screening; Meconium

Topics: Diatrizoate; Enema; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium

Routine intrapartum pharyngeal suctioning with a DeLee catheter of infants with meconium staining has significantly reduced the incidence and severity of meconium aspiration syndrome (MAS). There have been no adverse sequelae to this procedure, which is carried out while the infant's head is on the perineum, prior to the onset of respirations. Routine suctioning of the trachea under direct vision after delivery is rarely necessary but should be done if meconium is visualized at the vocal cords. Tracheobronchial lavage with saline may add to the respiratory morbidity. No deaths or severe cases of MAS have occurred since institution of the obstetric suctioning procedure.

Topics: Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intubation, Intratracheal; Meconium; Pneumonia, Aspiration; Pregnancy; Sodium Chloride; Suction; Syndrome; Therapeutic Irrigation

Topics: Apgar Score; Diseases in Twins; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Radiography

Topics: Cystic Fibrosis; Evaluation Studies as Topic; False Positive Reactions; Humans; Infant, Newborn; Infant, Newborn, Diseases; Mass Screening; Meconium; Methods

Topics: Airway Obstruction; Asphyxia Neonatorum; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Resuscitation

Experimental evidence suggests that Gastrografin in the neonatal gastrointestinal tract leads to hypertonic dehydration by two mechanisms: loss of water from the circulating blood volume, and absorption of osmolarly active substances across intact, normal mucosa of the gastrointestinal tract. Clinical documentation of absorption of Gastrografin is presented. Renal excretion of contrast material was seen following its use in the treatment of meconium ileus.

Topics: Diatrizoate; Diatrizoate Meglumine; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Absorption; Intestinal Obstruction; Kidney; Meconium; Radiography, Abdominal; Urinary Bladder

Topics: Albumins; Cystic Fibrosis; Humans; Hungary; Infant, Newborn; Infant, Newborn, Diseases; Mass Screening; Meconium

In a retrospective analysis of infants born with meconium staining over an 18-month period at Cook County Hospital, 32 infants met two of the three criteria for the diagnosis of meconium aspiration syndrome: (1) history of meconium in the oropharynx or trachea; (2) clinical evidence of respiratory distress; and (3) x-ray evidence of aspiration pneumonia. Seventeen infants developed respiratory failure; nine of these infants died. One infant without respiratory failure died of sepsis. Analysis of sequential arterial blood pH and gas tension showed that nonsurviving infants had persistently high PCO2 and A-a gradient in spite of initiation of assisted ventilation. These changes seem to be related to severe right-to-left shunting and ventilation perfusion abnormalities. The data further suggest that asphyxia and acidosis occur well before the infant is born and that intrapartum monitoring to recognize fetal asphyxia may help in improving morbidity and mortality from meconium aspiration syndrome.

Topics: Blood Gas Analysis; Humans; Hydrogen-Ion Concentration; Infant, Newborn; Infant, Newborn, Diseases; Inhalation; Intermittent Positive-Pressure Breathing; Intubation, Intratracheal; Meconium; Pneumonia, Aspiration; Radiography; Respiration; Respiratory Distress Syndrome, Newborn; Resuscitation; Syndrome; Ventilators, Mechanical

The effectiveness of meconium screening for albumin as an indication of cystic fibrosis is examined. BM-Test Meconium was applied to 69,000 investigations. In 60 positive tests, cystic fibrosis was confirmed later. No increased albumin content was observed in four cases of cystic fibrosis.

Topics: Albumins; Cystic Fibrosis; Evaluation Studies as Topic; False Negative Reactions; False Positive Reactions; Humans; Immunodiffusion; Indicators and Reagents; Infant; Infant, Newborn; Infant, Newborn, Diseases; Iontophoresis; Mass Screening; Meconium; Methods; Phenolphthaleins; Pilocarpine; Reagent Strips

A qualitative method of detecting elevated meconium protein concentration was compared with a method of determining meconium albumin concentration by electroimmunoassay since elevated meconium protein levels can indicate pancreatic insufficiency caused by cystic fibrosis. Between 5 and 10 per 1000 healthy infants passed meconium specimens that gave a false positive reaction with the Boehringer Mannheim test strip and contained a greater than expected concentration of albumin. It was possible to exclude pancreatic insufficiency in all of these children by determining the ratio, albumin : alpha1-antitrypsin in meconium and subsequent faecal specimens, since it was found that values of this ratio in excess of 2.0 suggested pancreatic insufficiency of the type associated with cystic fibrosis. Three of 14 neonates with subsequently proven cystic fibrosis yielded meconium specimens giving negative test strip results and low albumin concentrations. In two of these patients, the ratio, albumin : alpha1-antitrypsin in the meconium was within normal limits but, within two months of birth, the albumin : alpha1-antitrypsin ratio in the faeces of both children was greater than 3.0 suggesting that pancreatic insufficiency had developed.

Topics: Albumins; alpha 1-Antitrypsin; Chymotrypsin; Cystic Fibrosis; Feces; Humans; Immunoelectrophoresis; Infant, Newborn; Infant, Newborn, Diseases; Mass Screening; Meconium; Methods

The effectiveness of end-expiratory pressure (EEP) in relieving hypoxemia in the meconium aspiration syndrome (MAS) was studied in 14 patients with the disorder. These infants demonstrated a direct, mean PO2 response of 12 torr/cm H2O EEP. A maximum PO2 response was observed in an EEP range of 4 to 7 cm H2O. EEP was equally effective whether patients were breathing spontaneously or were being mechanically ventilated. EEP is useful in the treatment of hypoxemia in the infants with meconium aspiration syndrome.

Topics: Blood Gas Analysis; Humans; Infant, Newborn; Infant, Newborn, Diseases; Inhalation; Intubation, Intratracheal; Meconium; Positive-Pressure Respiration; Respiration; Respiratory Distress Syndrome, Newborn; Syndrome

Meconium staining of the placenta and/or fetal body was present at birth in 10.3 per cent of 42,000 live-born infants, but present disproportionately in 18.1 per cent of 788 neonatal deaths. The neonatal mortality rate was 3.3 per cent in the stained group and 1.7 per cent in the nonstained group. Among infants who died, the incidence of erythroblastosis was quadrupled and that of cardiovascular malformation was doubled in the stained group. Meconium staining was associated with a decrease in the expected frequency of hyaline membranes and atelectasis even in premature infants; hypotheses for this phenomenon were presented. Meconium staining of the fetus or placenta requires several hours of exposure. As a hypothesis, the observed increase of deaths in stained neonates may be related to the stresses of cumulative or chronic hypoxia which may occur after the initial passage of meconium if delivery is prolonged.?23AUTHOR

Topics: Amniotic Fluid; Autopsy; Birth Weight; Congenital Abnormalities; Erythroblastosis, Fetal; Female; Fetal Diseases; Hemorrhage; Humans; Hyaline Membrane Disease; Hypoxia; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Obstetric Labor Complications; Placenta; Pneumonia; Pregnancy; Pregnancy Complications; Pregnancy in Diabetics; Pulmonary Atelectasis; Time Factors

Topics: Colonic Diseases, Functional; Diagnosis, Differential; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Intestinal Obstruction; Meconium; Megacolon; Pregnancy; Pregnancy in Diabetics; Radiography

Topics: Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Methods; Peritonitis

A five-year review of 127 elderly patients (35 years of age and over), in their first pregnancies, defines the risk to the fetus in terms of perinatal death and neonatal morbidity. With the equivalent of a perinatal mortality rate of 94/1,000, an 11 per cent incidence of small-for-dates infants, and a neonatal morbidity rate of 18 per cent, there would still appear to be a need for an increased awareness of the fetal risks in this group and an increased emphasia on their prevention. Areas of management in prenatal care and labor which might reduce these figures are defined.

Topics: Adult; Apgar Score; Birth Weight; Cesarean Section; Congenital Abnormalities; Delivery, Obstetric; Extraction, Obstetrical; Female; Fetal Death; Fetal Diseases; Follow-Up Studies; Gestational Age; Humans; Infant Mortality; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature; Labor, Induced; Labor, Obstetric; Maternal Age; Meconium; Middle Aged; Parity; Pregnancy; Pregnancy Complications; Pregnancy, Prolonged

An incidence of the genetic recessive disease cystic fibrosis (mucoviscidosis) far in excess of that reported recently from other countries, has been encountered in the South West African Afrikaner. This has probably resulted from the immigration of a segment of the South African Afrikaner population rich in the gene, into South West Africa, where, for religious reasons and reasons of geographical isolation, the gene has persisted and, perhaps, increased in frequency. Malaria, which killed many of the early settlers, might have selectively spared carriers of the gene, thus enriching its occurrence in the population. Details of patients, particularly with regard to the criteria of diagnosis, are given with the relevant population and birth figures, from which an estimate of the incidence of the disease and of its carrier rate has been made. Screening of the newborn for the condition and the compiling of a register of potential and obligatory carriers are also discussed.

Topics: Africa, Southern; Child; Cystic Fibrosis; Gene Frequency; Heterozygote; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Mass Screening; Meconium; White People

We performed a retrospective study of the morbidity and mortality rates of 125 infants, born through meconium-stained amniotic fluid, and admitted to the newborn intensive-care unit for observation. A comparison was made of maternal age, history of toxemia, type of anesthesia, duration of analgesia, presence of cord complications, abnormalities of fetal heart rate, duration of meconium staining, birth weight, gestational age, 1 and 5 minute Apgar scores, and type of resuscitation between infants who were symptomatic or asymptomatic in the unit. Forty-three developed respiratory distress (symptomatic) and eight died; 82 were asymptomatic. The only difference between the two groups was a history of immediate tracheal suction in the delivery room. Of 97 infants receiving immediate tracheal suction, 27 became symptomatic and one died--an infant with Down's syndrome and endocardial cushion defect. On the other hand, of 28 infants who did not receive immediate tracheal suction, 16 became symptomatic and seven died of massive meconium aspiration pneumonitis (P less than 0.001). We concluded that in infants born through meconium-stained amniotic fluid, immediate tracheal suction is a safe procedure that significantly lowers the morbidity and mortality rates and produces no further respiratory depression of the infant.

Topics: Amniotic Fluid; Apgar Score; Autopsy; Birth Weight; Catheterization; Drainage; Female; Gestational Age; Humans; Infant, Newborn; Infant, Newborn, Diseases; Inhalation; Intubation, Intratracheal; Laryngoscopy; Meconium; Methods; Pneumonia, Aspiration; Pregnancy; Respiratory Distress Syndrome, Newborn; Retrospective Studies; Trachea

A report is presented of a newborn baby who developed a pneumothorax and extensive surgical emphysema after being delivered by Caesarean section for fetal distress soon after the mother had an amniocentesis.

Topics: Adult; Amniocentesis; Amniotic Fluid; Apgar Score; Cesarean Section; Emphysema; Female; Fetal Heart; Heart Rate; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Pneumothorax; Pregnancy; Radiography

An animal model of meconium aspiration was developed to determine the efficacy of glucocorticoids in its treatment. Rabbit pups were made to aspirate either meconium or saline prior to the onset of respiration. Cortisol was administered in a random, blind fashion. Slight decrease in respiratory rate and less severe histopathologic changes in the lungs were seen in corticosteroid-treated animals. Survival was significantly decreased, without definite cause, in the glucocorticoid-treated animals whether or not they had aspirated meconium. Because of this decreased survival and the relatively insignificant improvement in clinical course and histopathology found with glucocorticoid treatment, we cannot recommend cortisol for the treatment of meconium aspiration.

Topics: Animals; Body Weight; Disease Models, Animal; Female; Humans; Hydrocortisone; Infant, Newborn; Infant, Newborn, Diseases; Inhalation; Lung; Meconium; Organ Size; Oxygen Consumption; Pregnancy; Rabbits; Sodium Chloride

Eleven cases of intestinal occlusion (4 personal and 7 culled from hospital records) are presented. The importance of certain symptoms, early diagnosis and the need for minimum trauma in surgical management are discussed.

Topics: Cystic Fibrosis; Digestive System Abnormalities; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium

Topics: Appendicitis; Barium Sulfate; Constipation; Diverticulum; Duodenal Diseases; Duodenal Obstruction; Duodenum; Enema; Humans; Ileum; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Obstruction; Intestine, Small; Meconium; Megacolon; Preoperative Care; Radiography; Syndrome

Topics: Age Factors; Anal Canal; Bacterial Infections; Bacteriological Techniques; Ear, External; Escherichia coli; Eye; Humans; Infant, Newborn; Infant, Newborn, Diseases; Klebsiella pneumoniae; Listeria monocytogenes; Meconium; Moraxella; Mouth; Nose; Pharynx; Proteus; Pseudomonas aeruginosa; Skin; Staphylococcus; Stomach; Streptococcus; Umbilicus

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Peritonitis

Topics: Amniotic Fluid; Asphyxia Neonatorum; Birth Weight; Cholestasis; Female; Fetal Death; Follow-Up Studies; Gestational Age; Hepatitis A; Humans; Infant, Newborn; Infant, Newborn, Diseases; Jaundice; Male; Maternal-Fetal Exchange; Meconium; Obstetric Labor Complications; Pregnancy; Pregnancy Complications; Pregnancy Complications, Infectious; Pruritus; Recurrence

Topics: Age Factors; Culture Media; Feces; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Methods; Metronidazole; Pregnancy; Pregnancy Complications, Infectious; Pyuria; Trichomonas vaginalis; Trichomonas Vaginitis; Vaginal Smears

Topics: Drainage; Humans; Hyaline Membrane Disease; Infant; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Inhalation; Meconium; Methods; Pneumothorax; Respiration, Artificial

Topics: Barium Sulfate; Colon; Colonic Diseases; Diagnosis, Differential; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium; Megacolon; Radiography

Topics: Colonic Diseases; Diagnosis, Differential; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium; Megacolon; Radiography

Topics: Amniocentesis; Amniotic Fluid; Apgar Score; Emphysema; Female; Fetal Diseases; Gestational Age; Humans; Infant, Newborn; Infant, Newborn, Diseases; Labor, Obstetric; Meconium; Pneumothorax; Pregnancy; Pregnancy, Prolonged; Prenatal Diagnosis; Punctures; Radiography; Skin

Topics: Central Nervous System Diseases; Child Development; Congenital Abnormalities; Emaciation; Female; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Prospective Studies; Respiratory Tract Infections; Sleep Wake Disorders; Social Behavior; Syndrome; Thumb

Topics: Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Radiography; Therapeutic Irrigation

Topics: Albumins; Cystic Fibrosis; False Negative Reactions; False Positive Reactions; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Mass Screening; Meconium; Prognosis

Topics: Apgar Score; Asphyxia Neonatorum; Birth Weight; Carbon Dioxide; Cardiac Catheterization; Cyanosis; Diagnosis, Differential; Female; Follow-Up Studies; Gestational Age; Heart Defects, Congenital; Humans; Hypertension, Pulmonary; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Obstetric Labor Complications; Oxygen; Partial Pressure; Pregnancy; Pulmonary Artery; Radiography

Topics: Albumins; Chromatography; Costs and Cost Analysis; Cystic Fibrosis; False Positive Reactions; Humans; Infant, Newborn; Infant, Newborn, Diseases; Mass Screening; Meconium; Methods; Proteins

Topics: Diatrizoate; Enema; Fluoroscopy; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Intestinal Obstruction; Meconium; Methods; Pneumonia

Topics: Acid-Base Equilibrium; Acidosis; Alberta; Amniotic Fluid; Anesthesia, Obstetrical; Apgar Score; Autonomic Nerve Block; Blood; Carbon Dioxide; Delivery, Obstetric; Female; Fetal Heart; Fetus; Heart Rate; Humans; Hydrogen-Ion Concentration; Infant, Newborn; Infant, Newborn, Diseases; Labor, Obstetric; Meconium; Meperidine; Oxygen; Partial Pressure; Pregnancy; Promethazine; Sweden

Topics: Cystic Fibrosis; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Lung Diseases, Obstructive; Male; Meconium; Pregnancy; Prognosis; Rectal Prolapse; Sweat; Trypsin

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Perforation; Meconium; Peritonitis

Topics: Adult; Calcinosis; Diagnosis, Differential; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Inguinal Canal; Male; Meconium; Peritonitis; Radiography; Testis

Topics: Anthropometry; Asphyxia Neonatorum; Birth Weight; Child Development; Congenital Abnormalities; Emaciation; Female; Fetal Death; Fetal Diseases; Gestational Age; Humans; Infant; Infant Mortality; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Nails; Neurologic Manifestations; Organ Size; Pregnancy; Pregnancy, Prolonged; Sleep Wake Disorders; Social Behavior; Thumb; Umbilical Cord

Topics: Animals; Diagnosis, Differential; Humans; Infant Nutritional Physiological Phenomena; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Milk; Radiography; Syndrome

Topics: Apgar Score; Gestational Age; Humans; Infant, Newborn; Infant, Newborn, Diseases; Inhalation; Intubation, Intratracheal; Meconium; Pharynx; Radiography; Respiratory Insufficiency; Therapeutic Irrigation; Trachea

Topics: Adult; Extraembryonic Membranes; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Maternal-Fetal Exchange; Meconium; Placenta; Placenta Diseases; Pregnancy; Pregnancy Complications, Infectious; Sepsis; Skin Diseases, Infectious; Staphylococcal Infections; Staphylococcus; Umbilical Arteries

Topics: Abdomen; Calcinosis; Cystic Fibrosis; Cysts; Female; Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Peritonitis; Pregnancy; Radiography; Umbilicus

Topics: Feces; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Listeria monocytogenes; Listeriosis; Maternal-Fetal Exchange; Meconium; Pregnancy; Pregnancy Complications, Infectious

Topics: Autopsy; Central Nervous System; Cerebrospinal Fluid; Germany, East; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Listeria monocytogenes; Listeriosis; Meconium; Meningitis, Listeria; Organ Specificity

Topics: Amphotericin B; Arthritis; Candida albicans; Candidiasis; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Joint Diseases; Meconium; Meningitis; Periostitis; Radiography

Topics: Anal Canal; Body Fluids; Body Water; Body Weight; Deuterium; Duodenum; Esophageal Atresia; Hernia, Umbilical; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Obstruction; Jejunum; Meconium; Megacolon; Radioisotope Dilution Technique; Rectum; Tracheoesophageal Fistula; Water

Topics: Albumins; Cystic Fibrosis; Humans; Immunodiffusion; Infant, Newborn; Infant, Newborn, Diseases; Mass Screening; Meconium

Topics: Animals; Diatrizoate; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium; Milk; Radiography

Topics: Enema; Female; Fetus; Gastrointestinal Motility; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Magnesium; Magnesium Sulfate; Meconium; Pregnancy

Topics: Asphyxia Neonatorum; Female; Humans; Infant Mortality; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Oxygen Inhalation Therapy; Pregnancy; Respiratory Distress Syndrome, Newborn

Topics: Age Factors; Birth Weight; Cystic Fibrosis; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium; Postoperative Complications; Pyloric Stenosis; Time Factors

Topics: Catheterization; Female; Humans; Ileum; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Obstruction; Jejunum; Meconium; Postoperative Complications

Topics: Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Magnesium; Magnesium Sulfate; Maternal-Fetal Exchange; Meconium; Pre-Eclampsia; Pregnancy

Topics: Diagnosis, Differential; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Megacolon; Radiography

Topics: Appendicitis; Child; Child, Preschool; Diagnosis, Differential; Enterocolitis, Pseudomembranous; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Perforation; Intussusception; Meckel Diverticulum; Meconium; Pancreatitis; Peptic Ulcer Perforation; Peritonitis; Radiography

Topics: Duodenum; Emergencies; Esophageal Atresia; Female; Gastrointestinal Diseases; Hernia, Diaphragmatic; Hernia, Inguinal; Hernia, Umbilical; Hernia, Ventral; Hernias, Diaphragmatic, Congenital; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Obstruction; Intestinal Perforation; Jejunum; Meconium; Pneumothorax; Pregnancy; Pyloric Stenosis; Renal Veins; Rupture; Stomach Diseases; Thrombophlebitis

Topics: Asphyxia; Blood Transfusion; Color; Cyanosis; Female; Fetofetal Transfusion; Fetomaternal Transfusion; Gestational Age; Heart Defects, Congenital; Hematocrit; Hemorrhage; Humans; Infant, Newborn; Infant, Newborn, Diseases; Lung Diseases; Meconium; Oxygen Inhalation Therapy; Placenta Diseases; Positive-Pressure Respiration; Pregnancy; Resuscitation; Skin Manifestations

Topics: Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Peritonitis; Radiography

Topics: Birth Injuries; Ciliary Body; Delivery, Obstetric; Extraction, Obstetrical; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intracranial Pressure; Labor, Obstetric; Meconium; Occult Blood; Ophthalmoscopy; Peroxidases; Pregnancy; Retinal Hemorrhage; Retinal Vessels; Time Factors

Topics: Abdomen, Acute; Cysts; Diagnosis, Differential; Digestive System Abnormalities; Female; Follow-Up Studies; Hemangioma; Humans; Hydronephrosis; Infant, Newborn; Infant, Newborn, Diseases; Kidney Diseases; Kidney Neoplasms; Liver Neoplasms; Male; Meconium; Neuroblastoma; Ovarian Cysts; Peritonitis; Polycystic Kidney Diseases; Renal Veins; Retroperitoneal Neoplasms; Stomach Neoplasms; Teratoma; Thrombophlebitis; Uterine Diseases; Vaginal Diseases

Topics: Albumins; Cystic Fibrosis; False Negative Reactions; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium

Topics: Colon; Female; Ganglia; Humans; Ileum; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Diseases; Intestinal Obstruction; Intestine, Small; Laparotomy; Meconium; Thrombophlebitis; Vena Cava, Inferior

Topics: Autopsy; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Peritonitis

Topics: Diarrhea, Infantile; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Megacolon; Radiography; Therapeutic Irrigation

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Inhalation; Meconium; Mediastinal Emphysema; Pleural Effusion; Pneumothorax; Pulmonary Atelectasis; Radiography; Respiratory Distress Syndrome, Newborn; Respiratory Tract Diseases

Topics: Animals; Disease Models, Animal; Dogs; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Inhalation; Intubation, Intratracheal; Laparotomy; Meconium; Pregnancy; Radiography; Respiratory Tract Diseases; Uterus

Topics: Acute Disease; Autopsy; Chronic Disease; Colon, Sigmoid; Female; Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Perforation; Male; Meconium; Muscle, Smooth; Peritonitis; Pregnancy; Tissue Adhesions

Topics: Barium; Diagnosis, Differential; Enema; Humans; Ileum; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Diseases; Intestinal Obstruction; Intestine, Small; Meconium; Megacolon; Radiography

Topics: Agar; Enzyme Induction; Exchange Transfusion, Whole Blood; Humans; Hyperbilirubinemia; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Phenobarbital; Phototherapy

Topics: Acid-Base Equilibrium; Animals; Animals, Newborn; Barium Sulfate; Contrast Media; Dehydration; Depression, Chemical; Diatrizoate; Dogs; Enema; Hemodynamics; Humans; Hypertonic Solutions; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Methods; Plasma Volume; Sodium; Water-Electrolyte Balance

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Nitrogen; Pneumonia, Aspiration; Pulmonary Alveoli; Respiratory Insufficiency; Ventilation-Perfusion Ratio

Topics: Carrier State; Female; Fetus; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Pharynx; Placenta; Pregnancy; Pregnancy Complications, Infectious; Streptococcal Infections; Umbilical Cord

Topics: Duodenal Obstruction; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestine, Small; Meconium; Megacolon; Mesentery

Topics: Anal Canal; Barium Sulfate; Cecum; Child; Colitis; Colon; Diagnosis, Differential; Female; Fluoroscopy; Ganglia, Autonomic; Humans; Ileitis; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium; Megacolon; Rectal Diseases; Rectum

Topics: Contrast Media; Cystic Fibrosis; Diatrizoate; Enema; Female; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium; Peritonitis; Radiography

Topics: Female; Follow-Up Studies; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium; Methods; Postoperative Complications; Radiography

Topics: Diatrizoate; Enema; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Iodides; Meconium; Radiography

Topics: Colonic Diseases; Cystic Fibrosis; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Perforation; Meconium; Peritonitis; Radiography

Topics: Diagnosis, Differential; Dilatation; Female; Genital Diseases, Female; Genitalia, Female; Humans; Hymen; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Peritonitis; Radiography

Topics: Bone and Bones; Epithelium; Female; Fingers; Humans; Ichthyosis; Infant, Newborn; Infant, Newborn, Diseases; Keratins; Meconium; Muscles; Scalp; Skin; Thymus Gland; X-Ray Diffraction

Topics: Cathartics; Cystic Fibrosis; Enema; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Topics: Catheterization; Diagnosis, Differential; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infusions, Parenteral; Intestinal Obstruction; Male; Meconium; Megacolon; Pregnancy; Respiratory Distress Syndrome, Newborn; Sepsis; Umbilical Veins

Topics: Calcinosis; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Peritoneum

Topics: Anti-Bacterial Agents; Catheterization; Cystic Fibrosis; Germany, East; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Pneumonia; Postoperative Complications; Staphylococcal Infections

Topics: Apgar Score; Delivery, Obstetric; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Pregnancy

Topics: Cystic Fibrosis; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Methods; Peritonitis; Postoperative Complications

Topics: Abdomen; Abdominal Muscles; Abnormalities, Multiple; Colonic Diseases; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Topics: Amniotic Fluid; Bacteria; Culture Media; Culture Techniques; Escherichia coli; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infections; Listeria monocytogenes; Meconium; Pregnancy; Staphylococcus

Topics: Bronchopneumonia; Child, Preschool; Cystic Fibrosis; Fecal Impaction; Humans; Infant, Newborn; Infant, Newborn, Diseases; Japan; Liver; Lung; Male; Meconium; Pancreas; Radiography

Topics: Acetylcysteine; Animals; Dogs; Fecal Impaction; Gastrointestinal Hemorrhage; Humans; Hydrogen Peroxide; Hyperemia; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Viscosity

Topics: Anus, Imperforate; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Peritonitis

Topics: Adult; Animals; Female; Gelatin; Glucose; Glycine; Humans; Infant; Infant Nutritional Physiological Phenomena; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Intestinal Absorption; Intestinal Obstruction; Meconium; Milk; Pregnancy; Radiography; Xylose

Topics: Female; Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Laparotomy; Male; Meconium; Peritonitis; Philosophy, Medical; Pregnancy; Prenatal Care; Radiography; Torsion Abnormality

Topics: Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium

Topics: Birth Weight; Delivery, Obstetric; Drainage; Female; Humans; Hyaline Membrane Disease; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Mediastinal Emphysema; Methods; Pneumothorax; Radiography; Respiration, Artificial; Respiratory Distress Syndrome, Newborn

Topics: Amniotic Fluid; Cesarean Section; Color; Delivery, Obstetric; Female; Fetal Diseases; Humans; Hydrogen-Ion Concentration; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Pregnancy; Pregnancy Complications

Topics: Female; Gestational Age; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis; Pregnancy

Topics: Bone Development; Female; Femur; Humans; Humerus; Ilium; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium; Peritonitis; Pregnancy; Radiography; Scapula

Topics: Abnormalities, Multiple; Cystic Fibrosis; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium; Pancreas; Pancreatic Diseases

Topics: Cystic Fibrosis; Diatrizoate; Enema; Female; Fluoroscopy; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium; Methods

Topics: Cystic Fibrosis; Diagnosis, Differential; Humans; Ileum; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Methods; Prognosis

Topics: Female; Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Obstruction; Meconium; Methods; Pregnancy

Topics: Duodenal Diseases; Duodenal Ulcer; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Diseases; Intestinal Obstruction; Intestinal Perforation; Intestine, Small; Intussusception; Laparotomy; Meckel Diverticulum; Meconium; Methods; Peritonitis; Suture Techniques; Time Factors

Topics: Ampulla of Vater; Cystic Fibrosis; Female; Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Perforation; Male; Meconium; Peritonitis; Polyhydramnios; Pregnancy; Radiography

Topics: Anti-Bacterial Agents; Female; Fetal Death; Humans; Infant, Newborn; Infant, Newborn, Diseases; Listeria monocytogenes; Listeriosis; Maternal-Fetal Exchange; Meconium; Placenta; Pregnancy; Pregnancy Complications, Infectious

Topics: Barium; Colon; Fetus; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Obstruction; Meconium; Radiography; Time Factors

Topics: Asphyxia Neonatorum; Humans; Hyaline Membrane Disease; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Meconium; Pneumonia; Pneumothorax; Respiratory System Abnormalities; Respiratory Tract Diseases

Topics: Agglutination Tests; Blood Proteins; Cystic Fibrosis; Electrolytes; Humans; Infant, Newborn; Infant, Newborn, Diseases; Mass Screening; Meconium; Sweat; Trichloroacetic Acid

Topics: Diagnosis, Differential; Enema; Female; Humans; Hypoxia, Brain; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium; Megacolon; Radiography

Topics: Humans; Ileum; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium; Radiography

Topics: Asphyxia; Birth Weight; Brain Diseases; Child; Child, Preschool; Female; Follow-Up Studies; Gestational Age; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Motor Skills; Neurologic Examination; Pregnancy; Psychological Tests; Respiratory Distress Syndrome, Newborn

Topics: Ampicillin; Diagnosis, Differential; Female; Germany, East; Humans; Infant, Newborn; Infant, Newborn, Diseases; Listeriosis; Male; Meconium; Radiography, Thoracic

Topics: Albumins; Child; Child, Preschool; Cystic Fibrosis; Electrophoresis; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Nitrogen; Proteins; Sodium; Sweat

Topics: Acetylcysteine; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intubation, Gastrointestinal; Meconium; Radiography

Topics: Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Calcinosis; Genital Diseases, Male; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Male; Meconium; Peritonitis; Scrotum

Topics: Amnion; Asphyxia Neonatorum; Female; Germany, East; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Methods; Physical Examination; Pregnancy

Topics: Abdomen, Acute; Collateral Circulation; Cystic Fibrosis; Female; Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Perforation; Intestines; Male; Meconium; Peritoneum; Peritonitis; Pneumoperitoneum; Pregnancy; Radiography, Abdominal; Sepsis; Stomach Rupture

Topics: Enema; Humans; Hydrogen Peroxide; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Topics: Barium Sulfate; Biopsy; Chymotrypsin; Diagnosis, Differential; Feces; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Intestinal Obstruction; Intestine, Small; Male; Meconium; Megacolon; Radiography; Trypsin

Topics: Colostomy; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium; Parasympathetic Nervous System

Topics: Adult; Anaphylaxis; Enema; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Pregnancy; Soaps

Topics: Barium Sulfate; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Radiography, Abdominal

Topics: Animals; Dogs; Female; Humans; Ileum; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Absorption; Intestinal Atresia; Intestinal Diseases; Intestinal Obstruction; Intestine, Small; Jejunum; Male; Meconium; Postoperative Complications; Rabbits; Rats; Swine

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium; Radiography

Topics: Abdominal Muscles; Anus, Imperforate; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Perforation; Intestines; Male; Meconium; Megacolon

Topics: Cholestasis; Cystic Fibrosis; Esophageal Perforation; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Perforation; Male; Meconium; Polyhydramnios; Pregnancy; Prognosis

Topics: Agglutination Tests; Animals; Anti-Bacterial Agents; Diagnosis, Differential; Female; Granuloma; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Listeria monocytogenes; Listeriosis; Meconium; Meningitis, Listeria; Meningoencephalitis; Pregnancy; Sepsis; Zoonoses

Topics: Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium

Topics: Acidosis; Amniotic Fluid; Asphyxia; Asphyxia Neonatorum; Endoscopy; Erythroblastosis, Fetal; Female; Fetal Diseases; Hemoglobinometry; Humans; Infant, Newborn; Infant, Newborn, Diseases; Maternal-Fetal Exchange; Meconium; Pregnancy; Pregnancy Complications; Serum Albumin, Radio-Iodinated; Spectrophotometry; Tromethamine

Topics: Abdomen, Acute; Child, Preschool; Cystic Fibrosis; Duodenal Diseases; Esophagus; Female; Hirschsprung Disease; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Intestinal Obstruction; Intestinal Perforation; Male; Meckel Diverticulum; Meconium; Posture; Pyloric Stenosis; Radiography

Topics: Diagnosis, Differential; Female; Humans; Ileostomy; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Congenital Abnormalities; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestines; Male; Meconium

Topics: Colostomy; Enterocolitis, Pseudomembranous; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Perforation; Jejunum; Male; Meconium; Peptic Ulcer Perforation; Peritonitis; Pneumoperitoneum; Radiography; Sepsis; Stomach

Topics: Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Male; Meconium

Topics: Female; Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Listeria monocytogenes; Listeriosis; Meconium; Pregnancy

Topics: Animals; Diagnosis, Differential; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Listeria monocytogenes; Listeriosis; Meconium; Pregnancy; Pregnancy Complications, Infectious; Zoonoses

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Nursing; Peritonitis

Topics: Anti-Bacterial Agents; Colitis; Enema; Female; Hernia, Umbilical; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Perforation; Male; Meconium; Peritonitis; Pneumoperitoneum

Topics: Abdomen; Adult; Dystocia; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis; Pregnancy; Radiography

Topics: Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Pyridoxine; Respiratory Distress Syndrome, Newborn; Seizures; Vitamin B 6 Deficiency

Topics: Colonic Diseases; Diagnosis; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Perforation; Laparotomy; Meconium; Postoperative Care; Radiography; Surgical Procedures, Operative

Topics: Congenital Abnormalities; Cystic Fibrosis; Diagnosis; Female; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Pseudo-Obstruction; Meconium; Microbiology; Pathology; Polyhydramnios; Postoperative Complications; Pregnancy; Prognosis; Radiography; Statistics as Topic; Surgical Procedures, Operative

Topics: Cystic Fibrosis; Fetal Diseases; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Prognosis; Surgical Procedures, Operative

A mass of inspissated meconium in the distal colon or rectum is a relatively common cause of neonatal intestinal obstruction. The meconium-plug syndrome is unrelated to cystic fibrosis and meconium ileus. The clinical picture is frequently indistinguishable, without contrast study of the colon, from other forms of mechanical intestinal obstruction requiring laparotomy. A barium enema examination is almost always diagnostic, and use of this procedure usually results in dislodgement and passage of the plug.No single cause for the excessive viscosity and tenaciousness of the obstructive meconium mass has been identified. Previous reports have generally emphasized the normal ganglion-cell content of the colon in affected patients.Two infants are described who fulfilled all criteria for this syndrome but who were not rendered asymptomatic, as normally anticipated, by removal of the plug. Subsequent studies revealed the presence of Hirschsprung's disease in both patients. This diagnosis should be considered when an infant with meconium-plug obstruction of the colon fails to follow the usual satisfactory clinical course after the plug has been passed.

Topics: Barium Sulfate; Colonic Diseases; Colostomy; Cystic Fibrosis; Enema; Fetal Diseases; Hirschsprung Disease; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Laparotomy; Male; Meconium; Megacolon; Radiography; Rectum; Syndrome

Topics: Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Perforation; Meckel Diverticulum; Meconium; Peritonitis; Surgical Procedures, Operative

Surgeons whose practice involves many infants and children should be acquainted with all abnormalities of pancreatic malformation and function. Conditions amenable to surgical treatment are few, but serious. Trauma to the pancreas in childhood is most commonly diagnosed by fever, leukocytosis, rectus spasm and elevated serum amylase. Drainage of the lesser sac and debridement of devitalized tissue may prevent the sequelae of pseudocyst formation which seems to follow the untreated injury. True congenital cysts are characterized by an epithelial lining.Mucoviscidosis complicated by meconium ileus remains a challenging disease of the newborn that requires early operation. Ten per cent of infants with cystic fibrosis may be threatened by intestinal obstruction from this cause. Some children surviving the newborn period go on to develop obstruction later. Annular malformation of pancreas may produce upper intestinal (duodenal) obstructive symptoms immediately after birth. Surgical correction by duodenojejunostomy should be postponed only long enough to correct severe fluid or electrolyte imbalances. Idiopathic spontaneous hypoglycemia has the most serious prognosis if convulsions are allowed to recur. Increased metabolic rates in infants increase the need for control of blood sugar levels by either administration of cortisone or pancreatic resection. If adenoma is the cause, a conservative resection of the tumor suffices. If serial frozen section fails to reveal either tumor or hypertophy of insulin-producing cells, blind pancreatectomy may be indicated, for irreversible brain damage develops early in uncontrolled hypoglycemia.

Topics: Child; Congenital Abnormalities; Cystic Fibrosis; Drainage; Female; Humans; Hypoglycemia; Infant; Infant, Newborn; Infant, Newborn, Diseases; Insulin; Intestinal Obstruction; Meconium; Neoplasm Recurrence, Local; Pancreas; Pancreatectomy; Pancreatic Cyst; Pancreatic Diseases; Surgical Procedures, Operative

Topics: Cystic Fibrosis; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Pathology; Radiography

Topics: Anal Canal; Anus, Imperforate; Congenital Abnormalities; Diagnosis; Gastrointestinal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Megacolon; Radiography

Topics: Biometry; Congenital Abnormalities; Gastrointestinal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Statistics as Topic

Topics: Calcinosis; Cystic Fibrosis; Humans; Ileostomy; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Intestinal Obstruction; Meconium; Radiography

Topics: Cystic Fibrosis; Diagnosis; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Two of 15 children who survived neonatal meconium ileus had "meconium ileus equivalent." They were treated with hydration, pancreatic enzyme therapy and antibiotics. One of these children died from pulmonary disease at the time of the bowel obstruction. The survival rate of infants with meconium ileus is steadily improving because of prompt operative intervention, better preoperative and postoperative care and long-term treatment with enzyme supplements and antibiotics. Late intestinal obstruction due to adhesive bands, volvulus, intussusception or "meconium ileus equivalent" may occur in children previously treated for meconium ileus of infancy. The omission of pancreatic enzyme supplementation and the occurrence of respiratory infections are frequently associated with "meconium ileus equivalent."In this series of patients four of the infants treated surgically for neonatal meconium ileus died in the early postoperative period.

Topics: Anti-Bacterial Agents; Child; Cystic Fibrosis; Fetal Diseases; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Pseudo-Obstruction; Intestinal Volvulus; Intussusception; Male; Meconium; Pancreas; Peritoneal Diseases; Postoperative Care; Respiratory Tract Infections; Surgical Procedures, Operative; Survival Rate

Topics: Barium; Barium Sulfate; Cystic Fibrosis; Enema; Humans; Ileus; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Radiography; Radiography, Abdominal

Topics: Calcinosis; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Perforation; Meconium; Peritonitis

Topics: Female; Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Meconium; Peritonitis; Pregnancy

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Topics: Adolescent; Child; Cystic Fibrosis; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Pathology; Postoperative Complications; Prognosis; Surgical Procedures, Operative

Topics: Autopsy; Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis; Radiography

Topics: Asphyxia Neonatorum; Boston; Child; Fatty Liver; Hospitals; Hospitals, Pediatric; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Pyridoxine

Topics: Humans; Ileum; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Obstruction; Intestinal Perforation; Meconium; Peritonitis; Postoperative Care; Radiography; Surgical Procedures, Operative

Topics: Amniotic Fluid; Ear, Middle; Humans; Infant; Infant Mortality; Infant, Newborn; Infant, Newborn, Diseases; Leukocytes; Lymphocytes; Meconium; Otitis Media; Pathology; Temporal Bone

Topics: Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Pathology; Surgical Procedures, Operative; Testicular Hydrocele

Topics: Calcinosis; Congenital Abnormalities; Cystic Fibrosis; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Obstruction; Intestinal Perforation; Meconium; Peritonitis; Surgical Procedures, Operative

Topics: Diagnosis; Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Pathology; Peritonitis; Surgical Procedures, Operative

Topics: Adolescent; Cystic Fibrosis; Humans; Ileus; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Secretions; Meconium; Pancreatic Extracts; Pathology; Postoperative Complications; Surgical Procedures, Operative; Tetracycline

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Perforation; Liver Diseases; Meconium; Megacolon; Peritonitis; Pseudomonas Infections; Radiography; Sepsis

Topics: Calcinosis; Gastric Fistula; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature; Intestinal Fistula; Meconium; Peritonitis; Radiography; Surgical Procedures, Operative

Topics: Adrenal Gland Diseases; Congenital Abnormalities; Emergencies; Esophagus; Hemorrhage; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Obstruction; Meconium; Peritonitis; Radiography

Topics: Acetylcysteine; Child; Cysteine; Cystic Fibrosis; Diagnosis; Humans; Ileus; Infant; Infant Nutritional Physiological Phenomena; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Pseudo-Obstruction; Intussusception; Meconium; Pancreatic Extracts; Rectal Prolapse; Surgical Procedures, Operative

Topics: Acetylcysteine; Cysteine; Cystic Fibrosis; Fetal Diseases; Hernia, Umbilical; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Perforation; Meconium; Peritonitis; Surgical Procedures, Operative

Topics: Calcinosis; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Perforation; Male; Meconium; Peritoneum; Peritonitis; Scrotum

Topics: Fetal Diseases; Fetus; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Peritonitis; Testicular Hydrocele

Topics: Fetal Diseases; Granuloma; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Intestinal Perforation; Meckel Diverticulum; Meconium; Pathology; Peritonitis

Topics: Feces; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis; Umbilical Cord

Topics: Congenital Abnormalities; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Pancreas; Pancreatic Neoplasms; Pancreatitis; Surgical Procedures, Operative

Topics: Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Obstruction; Intestinal Perforation; Meconium; Peritonitis; Surgical Procedures, Operative

Topics: Abdomen; Abdomen, Acute; Cystic Fibrosis; Gastrointestinal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Obstruction; Meconium; Megacolon; Peritonitis; Surgical Procedures, Operative

Topics: Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis; Radiography; Radiology

Topics: Cystic Fibrosis; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Perforation; Meconium; Peritonitis; Survivors

Topics: Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Cystic Fibrosis; Humans; Ileus; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Topics: Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature, Diseases; Meconium; Peritonitis; Radiography; Surgical Procedures, Operative

Topics: Contrast Media; Cystic Fibrosis; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Volvulus; Meconium; Peritonitis; Radiography; Surgical Procedures, Operative

Topics: Adrenal Insufficiency; Congenital Abnormalities; Cysts; Hernia, Umbilical; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Diseases; Intestinal Obstruction; Intussusception; Meconium; Megacolon; Mesenteric Vascular Occlusion; Pathology; Peritonitis; Surgical Procedures, Operative

Topics: Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Medical Records; Peritonitis

Topics: Calcification, Physiologic; Child; Disease; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Diseases; Intestines; Meconium

Topics: Child; Female; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis; Pregnancy; Prenatal Diagnosis

Topics: Fetal Diseases; Humans; Ileus; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Obstruction; Intestine, Small; Meconium; Peritonitis

Topics: Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Topics: Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Fetal Diseases; Humans; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Fetal Diseases; Fetus; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Cystic Fibrosis; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Peritonitis

In a review of cases of intestinal atresia or stenosis in the newborn at Children's Hospital of Los Angeles it was noted that in approximately 10 per cent there was clinical or anatomic evidence of fibrocystic disease of the pancreas. Histologic sections of the bowel in all these cases showed the alterations of the mucosa commonly found in fibrocystic disease. Extensive ulceration, foreign body reaction and calcium deposition in the bowel wall were observed in five cases. Sections through the site of obstruction in one patient showed narrowing of the diameter of the bowel with preservation of muscular layers, but replacement of the central portion by a vascular, fibrous diaphragm in which giant cells, hemosiderin and calcium were prominent. This suggested that in certain instances obstruction of the intestine may be caused by fibrosis secondary to injury of the mucosa by abnormal meconium. Awareness of the common association of intestinal obstruction and fibrocystic disease of the pancreas and recognition of the histologic change in the bowel in fibrocystic disease may lead to early diagnosis of this disorder in some infants with intestinal obstruction.

Topics: Child; Constriction, Pathologic; Cystic Fibrosis; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Obstruction; Intestines; Los Angeles; Meconium; Pancreas

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Cystic Fibrosis; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Pseudo-Obstruction; Meconium

Topics: Child; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Pancreas; Pancreatic Diseases; Peritonitis

Topics: Child; Humans; Infant; Infant, Newborn, Diseases; Intestinal Atresia; Intestines; Meconium; Peritonitis

Topics: Child; Cystic Fibrosis; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Pseudo-Obstruction; Meconium

Topics: Child; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Listeriosis; Meconium

Topics: Child; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Obstruction; Intestines; Meconium

Topics: Child; Disease; Female; Humans; Ileum; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis; Uterine Perforation

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Drainage; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis; Physical Examination

Topics: Child; Humans; Infant; Infant, Newborn, Diseases; Meconium; Osteosclerosis; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Ascites; Child; Dystocia; Female; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Peritonitis; Pregnancy

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

With the present-day development and understanding of anesthetic methods, fluid and electrolyte therapy, antibiotic medications and pediatric care, many congenital anomalies once uniformly fatal are now being successfully treated by emergency operations in the neonatal period. The eight most common of these which demand emergency operation in the immediate postnatal period are esophageal atresia and tracheoesophageal fistula, diaphragmatic hernia with dislocation of the abdominal viscera into the chest, malrotation of the intestine with obstruction, intestinal atresia, meconium ileus, imperforate anus, omphalocele and myelomeningocele. Although infants born with any of these serious problems often are born prematurely and often have more than one congenital anomaly, survival rates in the surgical treatment of these conditions are steadily improving. Early diagnosis and prompt treatment are the most important factors in the continued improvement of these survival rates.

Topics: Anus, Imperforate; Child; Esophageal Atresia; Fetal Diseases; Hernia, Diaphragmatic; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Obstruction; Meconium; Tracheoesophageal Fistula

Topics: Child; Cystic Fibrosis; Fetal Diseases; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Proteins

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature; Infant, Premature, Diseases; Meconium; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Digestive System Abnormalities; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Volvulus; Intestines; Meconium

Topics: Child; Humans; Ileus; Infant; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meckel Diverticulum; Meconium; Peritonitis; Rupture

Topics: Child; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Topics: Cystic Fibrosis; Humans; Ileus; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Viscosity

Topics: Amniotic Fluid; Child; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Disease; Fetal Diseases; Fetus; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Topics: Child; Feces; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Cystic Fibrosis; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Peritonitis

Topics: Child; Diaphragm; Humans; Infant; Infant, Newborn, Diseases; Meconium; Mucous Membrane; Peritonitis; Stomach Diseases

Topics: Child; Cystic Fibrosis; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Pulmonary Atelectasis

Topics: Child; Fetal Diseases; Humans; Ileus; Infant; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Topics: Child; Cystic Fibrosis; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intussusception; Meconium; Peritonitis

Topics: Child; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Topics: Child; Disease; Humans; Infant; Infant, Newborn, Diseases; Meconium; Pancreas; Pancreatic Diseases; Peritonitis

Topics: Child; Cystic Fibrosis; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Any newborn who continues to vomit in the first few days of life, particularly if the vomitus contains bile and if the abdomen is distended, should have immediate investigation because intestinal obstruction in the newborn is a fatal condition unless promptly recognized and surgically corrected. The most common cause of obstruction at this age is atresia and the simplest possible surgical procedure which adequately corrects this deformity should be done. It is also possible to successfully correct the obstruction caused by other congenital deformities such as annular pancreas and meconium ileus. Although prematurity is a definite factor in the outcome, intestinal obstruction in the newborn can be corrected with a surprisingly low mortality. Occasionally unusual methods are needed to tide these infants over the critical period of postoperative care.

Topics: Child; Cystic Fibrosis; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature; Intestinal Obstruction; Meconium; Pancreas; Pancreatic Diseases

Topics: Child; Humans; Ileus; Infant; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Colostomy; Cystic Fibrosis; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Topics: Child; Cystic Fibrosis; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritoneum; Peritonitis

Topics: Child; Duodenum; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Humans; Infant; Infant, Newborn, Diseases; Meconium; Minnesota; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Cystic Fibrosis; Disease; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestine, Small; Meconium; Pancreas; Pancreatic Diseases; Survivors

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Cystic Fibrosis; Disease; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Diseases; Intestinal Obstruction; Intestines; Meconium; Pancreas; Pancreatic Diseases

Topics: Calcification, Physiologic; Calcinosis; Child; Disease; Genital Diseases, Male; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Peritonitis; Scrotum

Topics: Child; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Peritonitis

Topics: Child; Disease; Hernia; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestines; Meconium; Mesentery; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Cystic Fibrosis; Disease; Humans; Ileum; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Volvulus; Meconium; Pancreas; Pancreatic Diseases; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Fetal Diseases; Humans; Ileus; Infant; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Disease; Humans; Hydrogen Peroxide; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Pancreas; Pancreatic Diseases

Topics: Child; Cystic Fibrosis; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Congenital Abnormalities; Humans; Ileum; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Disease; Humans; Ileus; Infant; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Pancreas; Pancreatic Diseases; Twins

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Megacolon; Peritonitis

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Cystic Fibrosis; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Topics: Child; Fetal Diseases; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Infant, Premature; Infant, Premature, Diseases; Intestinal Obstruction; Meconium

Topics: Child; Fetal Diseases; Humans; Ileus; Infant; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Topics: Child; Humans; Infant; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Child; Colon; Disease; Exocrine Pancreatic Insufficiency; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Pancreas; Pancreatic Diseases

Topics: Child; Cystic Fibrosis; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Topics: Child; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Topics: Child; Cystic Fibrosis; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Topics: Child; Dystocia; Female; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Peritonitis; Pregnancy

Topics: Child; Cystic Fibrosis; Cysts; Disease; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Pancreas; Pancreatic Diseases

Topics: Child; Congenital Abnormalities; Digestive System Abnormalities; Gastrointestinal Tract; Humans; Ileum; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Topics: Child; Fetal Diseases; Humans; Ileus; Infant; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Topics: Child; Cystic Fibrosis; Disease; Humans; Ileus; Infant; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Pancreas; Pancreatic Diseases

Topics: Child; Cystic Fibrosis; Humans; Ileus; Infant; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Topics: Child; Health Services; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestines; Meconium

Topics: Cystic Fibrosis; Disease; Fetal Diseases; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Pancreas; Pancreatic Diseases; Peritonitis

Topics: Child; Cystic Fibrosis; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Topics: Child; Cystic Fibrosis; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Topics: Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Perforation; Intestines; Meconium; Peritonitis

Topics: Child; Cystic Fibrosis; Humans; Ileus; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Topics: Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Jejunum; Meconium; Peritonitis

Topics: Hirschsprung Disease; Humans; Ileus; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Megacolon; Mesentery

Topics: Cystic Fibrosis; Humans; Ileus; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Pancreas

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Cystic Fibrosis; Humans; Ileus; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Pancreas

Topics: Blood; Blood Group Antigens; Cystic Fibrosis; Humans; Ileus; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium; Polysaccharides

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Cystic Fibrosis; Humans; Ileus; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium

Because the clinical appearance of newborn infants having intestinal obstruction is disarmingly normal, vomiting is reason for immediate search for the cause. To this end the character of stools and meconium that are passed should be carefully observed, lest valuable time elapse before correct diagnosis is made. In three cases of volvulus observed by the authors, there was moderate to pronounced distention of the abdomen at birth-a sign which may be helpful in diagnosis. Roentgenograms are the most helpful diagnostic aid. Since the roentgenographic appearance of the normal infant abdomen differs from that of the adult, interpretations should be made with that in mind. In this connection the absence of gas shadows is significant. Although there are dangers in the use of barium in infants, early diagnosis is so important that use of the substance is justifiable if it will help in correct appraisal. The treatment is always surgical, and the procedure of choice is primary anastomosis. Proper preoperative and postoperative care and treatment, including maintenance of fluid and electrolyte balance and blood volume, are of great importance.

Topics: Adult; Disease; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestinal Volvulus; Intestines; Meconium; Vomiting

Topics: Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis

Topics: Abscess; Fetal Diseases; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Intestines; Meconium; Peritonitis

Topics: Celiac Disease; Cystic Fibrosis; Humans; Ileus; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Obstruction; Meconium