morphine and Syndrome

Meconium passage in newborn infants is a developmentally programmed event normally occurring within the first 24 to 48 hours after birth. Intrauterine meconium passage in near-term or term fetuses has been associated with fetomaternal stress factors and/or infection, whereas meconium passage in postterm pregnancies has been attributed to gastrointestinal maturation. Despite these clinical impressions, little information is available on the mechanism(s) underlying the normal meconium passage that occurs immediately after birth or during the intrauterine period of fetal development. Birth itself is a stressful process and it is possible that fetal stress-mediated biochemical events may regulate the meconium passage occurring either during labor or after birth. Aspiration of meconium during intrauterine life may result in or contribute to meconium aspiration syndrome (MAS), representing a continued leading cause of perinatal death. This article reviews aspects of meconium passage in utero, its consequences, and management.

Topics: Adult; Digestive System; Female; Fetal Death; Fetal Development; Fetal Distress; Humans; Infant, Newborn; Meconium; Meconium Aspiration Syndrome; Obstetrics; Parturition; Pregnancy; Pregnancy Outcome; Risk Factors; Syndrome

Intestinal obstruction in the newborn infant may be due to a variety of conditions, including atresia and stenosis, annular pancreas, malrotation, duplication cyst, meconium ileus, meconium plug syndrome and neonatal small left colon syndrome, and Hirschsprung's disease. Neonates with unrecognised intestinal obstruction deteriorate rapidly, show an increase of associated morbidity and appropriate surgical treatment becomes more hazardous. Early diagnosis depends largely on the prompt detection of obstructive manifestations by the clinician and the subsequent accurate interpretation of radiographic findings by the radiologist. Plain film of the abdomen is often helpful in determining the level of obstruction and usually dictates, together with clinical symptoms, the choice of the contrast study firstly to perform. In this article we will review the clinical and radiological signs of different pathological conditions causing intestinal obstruction in the newborn.

Topics: Colon; Constriction, Pathologic; Contrast Media; Cysts; Hirschsprung Disease; Humans; Infant, Newborn; Intestinal Atresia; Intestinal Diseases; Intestinal Obstruction; Intestines; Meconium; Pancreas; Radiography; Syndrome; Torsion Abnormality

Timely passage of the first stool is a hallmark of the well-being of the newborn infant. Failure of a full-term newborn to pass meconium in the first 24 hours may signal intestinal obstruction. Lower intestinal obstruction may be associated with disorders such as Hirschsprung's disease, anorectal malformations, meconium plug syndrome, small left colon syndrome, hypoganglionosis, neuronal intestinal dysplasia and megacystis-microcolon-intestinal hypoperistalsis syndrome. Radiologic studies are usually required to make the diagnosis. In addition, specific tests such as pelvic magnetic resonance imaging, anorectal manometry and rectal biopsy are helpful in the evaluation of newborns with failure to pass meconium.

Topics: Anal Canal; Colonic Diseases; Congenital Abnormalities; Diagnosis, Differential; Hirschsprung Disease; Humans; Infant, Newborn; Intestinal Obstruction; Male; Meconium; Rectum; Syndrome

Meconium-stained amniotic fluid occurs in approximately 12% of live births. In approximately one third of these infants meconium is present below the vocal cords. However, meconium aspiration syndrome develops in only 2 of every 1000 live-born infants. Ninety-five percent of infants with inhaled meconium clear the lungs spontaneously. Recent investigations have suggested that a reexamination of our assumptions about the etiology of meconium aspiration syndrome is in order. Several authors have provided evidence that support the hypothesis that it is not the inhaled meconium which produces the primary pathologic condition of meconium aspiration syndrome but rather it is fetal asphyxia that is the etiologic agent. Asphyxia in utero produces pulmonary vasospasm and hyperreactivity of the pulmonary vessels. With severe asphyxia the fetal lungs undergo pulmonary vascular damage with pulmonary hypertension. The damaged lungs are then unable to clear the meconium. In the most severe cases there is right-to-left shunting and persistent fetal circulation with subsequent fetal death. The incidence of meconium aspiration may thus be essentially unaffected by current obstetric and pediatric interventions at birth. For the asphyxiated or distressed infant we recommend suctioning at birth and tracheal intubation. In the healthy fetus observation may be sufficient.

Topics: Asphyxia Neonatorum; Fetal Distress; Humans; Infant, Newborn; Meconium; Meconium Aspiration Syndrome; Respiratory Insufficiency; Syndrome

Topics: Acidosis; Animals; Animals, Newborn; Asphyxia Neonatorum; Bacterial Infections; Cerebral Hemorrhage; Erythroblastosis, Fetal; Female; Fetal Diseases; Hepatitis, Animal; Horse Diseases; Horses; Humans; Hypoglycemia; Hypoxia; Infant, Newborn; Meconium; Nephritis; Pregnancy; Respiratory Insufficiency; Seizures; Syndrome; Virus Diseases

To determine risk factors for meconium aspiration syndrome (MAS).. A cohort study was conducted of 70 consecutive singleton pregnancies complicated with thick meconium-stained amniotic fluid delivered at > or = 37 weeks' gestation. Cases were randomized either for elective abdominal delivery or spontaneous vaginal delivery after 20 min of external fetal heart rate (FHR) monitoring. Risk estimation analysis for MAS was performed calculating relative risks (RR) and odds ratios (OR).. The presence of meconium below the vocal cords (RR=7.3, 95% CI=2.6-20.3), non-reassuring FHR tracings (RR=3.0, 95% CI=1.2-7.5), Apgar score < or = 6 at 5 min (RR=3.8, 95% CI=1.7-8.4) and an umbilical cord plasma erythropoietin (UCPer) level > 50 mlU/ml (RR=5.0, 95% CI=2.1-12.0) were found to be significant risk factors for MAS. The presence of meconium below the vocal cords (OR=33.4, 95% CI=3.6-303.7) and non-reassuring FHR tracings (OR=12.2, 95% CI=1.3-111.7) remained as significant risk factors at the end of the multivariate analysis.. Non-reassuring FHR tracings and the presence of meconium below vocal cords are associated with an increased risk for MAS in infants born through thick meconium.

Topics: Adult; Amniocentesis; Chi-Square Distribution; Cohort Studies; Confidence Intervals; Delivery, Obstetric; Female; Humans; Incidence; Infant, Newborn; Logistic Models; Meconium; Meconium Aspiration Syndrome; Multivariate Analysis; Obstetric Labor Complications; Pregnancy; Prognosis; Risk Factors; Syndrome

The null hypothesis is that the use of intrapartum amnioinfusion in labors complicated by the presence of thick meconium and oligohydramnios will not decrease the incidence of fetal distress, cesarean delivery, meconium aspiration, or meconium aspiration syndrome.. One hundred seventy term and postterm patients with thick meconium and oligohydramnios were randomly chosen to receive amnioinfusion or standard obstetric care without amnioinfusion. The frequency of fetal distress, cesarean section, meconium aspiration, and meconium aspiration syndrome were subject to chi 2 analysis, Student's t test, or Fisher's exact test.. The rate of fetal distress was significantly reduced in the amnioinfusion group compared with controls (three of 85 vs 19 of 85, relative risk 0.15, 95% confidence interval 0.06 to 0.42). The rate of cesarean section for fetal distress was significantly reduced in the amnioinfusion group (two of 85 vs 17 of 85, relative risk 0.118, confidence interval 0.03 to 0.49). The rates of meconium aspiration (four of 85 vs 33 of 85, relative risk 0.12, confidence interval 0.0449 to 0.327) and meconium aspiration syndrome (0 of 85 vs five of 85, relative risk 0.09, confidence interval 0.009 to 0.872) were significantly reduced by amnioinfusion.. Amnioinfusion improves the outcome in pregnancies complicated by thick meconium and oligohydramnios.

Topics: Amnion; Cesarean Section; Female; Fetal Distress; Humans; Hydrogen-Ion Concentration; Infant, Newborn; Meconium; Meconium Aspiration Syndrome; Obstetric Labor Complications; Oligohydramnios; Pregnancy; Prospective Studies; Sodium Chloride; Solutions; Syndrome; Umbilical Arteries

Meconium peritonitis is caused by an intestinal perforation that may occur in the fetus, followed by severe chemical peritonitis, resulting in high morbidity.. We have experienced six patients with meconium peritonitis. Cystic drainage was performed soon after birth for all patients. We investigated the concentrations of several cytokines and a chemokine (interleukin 8) in the ascites from the six patients with meconium peritonitis. In two patients we also measured the serum cytokines and chemokine level just after birth.. Interleukin 6 and interleukin 8 concentrations were very high in the cyst or ascites just after birth. In the serum taken from two patients, the levels of interleukin 6 and interleukin 8 were also high. In five patients who underwent drainage of cysts after birth, systemic inflammation could not be completely suppressed before curative surgery.. Interleukin 6 and interleukin 8 play important roles in the inflammatory response syndrome associated with meconium peritonitis, and drainage of cystic fluid did not completely suppress this inflammation. To lessen the high morbidity of meconium peritonitis, efforts should be made to suppress the inflammatory response using new treatment strategies, such as administration of steroids or anti-cytokine therapy to supplement cystic drainage.

Topics: Ascites; C-Reactive Protein; Chemokines; Cyst Fluid; Cytokines; Drainage; Fatal Outcome; Female; Fetal Diseases; Hernia, Diaphragmatic; Humans; Infant, Newborn; Interleukin-6; Interleukin-8; Intestinal Perforation; Male; Meconium; Peritonitis; Prognosis; Syndrome

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

Topics: Barium Sulfate; Cystic Fibrosis; Enema; Female; Hirschsprung Disease; Humans; Ileal Diseases; Incidence; Infant, Newborn; Intestinal Obstruction; Male; Meconium; Retrospective Studies; Syndrome; Treatment Outcome

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

Meconium aspiration syndrome is a serious condition of the newborn characterized by pulmonary inflammation with substantial neutrophil infiltration. We recently showed that meconium is a potent activator of complement. The aim of the present study was to investigate a possible role for complement in meconium-induced neutrophil activation. Meconium was incubated in human whole blood anticoagulated with lepirudin, a specific thrombin inhibitor that does not affect complement activation. Complement activation was detected by measuring the terminal complement complex. Neutrophil oxidative burst and changes in CD11b and L-selectin expression were measured by flow cytometry. Complement was inhibited using the MAb 166-32 and 137-26, which block factor D and neutralize C5a, respectively. Meconium markedly activated the neutrophils, as revealed by up-regulation of CD11b, accentuation of L-selectin shedding, and induction of oxidative burst. Complement inhibition using the anti-factor D antibody completely (95-100%) blocked meconium-induced changes in CD11b and L-selectin expression, whereas oxidative burst was reduced by 60-70%. The anti-C5a antibody inhibited the neutrophil activation to the same extent as anti-factor D. The data suggest that complement activation is largely responsible for the neutrophil inflammatory responses induced by meconium in vitro and that C5a is a key mediator of this response.

Topics: Antibodies, Monoclonal; CD11b Antigen; Complement Activation; Complement C5a; Complement System Proteins; Dose-Response Relationship, Drug; Flow Cytometry; Hirudins; Humans; Infant, Newborn; Inflammation; L-Selectin; Meconium; Meconium Aspiration Syndrome; Neutrophil Activation; Neutrophils; Oxidative Stress; Protein Binding; Recombinant Proteins; Respiratory Burst; Syndrome

Topics: Biological Products; Fluorocarbons; Humans; Hydrocarbons, Brominated; Infant, Newborn; Meconium; Meconium Aspiration Syndrome; Pulmonary Surfactants; Surface Tension; Syndrome

Respiratory failure caused by meconium aspiration requires combined strategies. We hypothesized that surfactant lung lavage with asymmetric high-frequency jet ventilation (AHFJV) can increase the removal of meconium and improve lung function. During conventional ventilation (CV), a suspension of human meconium (25 mg/ml, 4 ml/kg) was instilled into the tracheal tube of anesthetized rabbits to cause respiratory failure. Animals were then divided into four groups: saline lavage + CV (Sal-CV), surfactant lavage + CV (Surf-CV), saline lavage + HFJV (Sal-HFJV), and surfactant lavage + HFJV (Surf-HFJV). Lung lavage (10 ml/kg in 3 portions) was performed with diluted surfactant (Curosurf, 100 mg of phospholipids/kg) or saline during CV (frequency (f), 30/min; inspiration time (Ti), 50%) or AHFJV (f, 300/min; Ti, 70%). Animals were ventilated for an additional hour with either CV or HFJV (Ti, 50%). Surfactant lavage with both CV and AHFJV removed more meconium than saline lavage. However, the highest removal was found in the Surf-HFJV group vs. all other groups (P < 0.05). The oxygenation index decreased after surfactant lavage in both groups compared to controls (P < 0.001), and more prominently in the Surf-CV group. Elimination of CO(2) was significantly higher in the Surf-HFJV group vs. all other groups (P < 0.05). The ventilation efficiency index increased after lavage in both surfactant groups vs. saline controls (P < 0.05). Dynamic lung-thorax compliance gradually increased, and right-to-left pulmonary shunts decreased in both surfactant groups vs. saline controls after lavage (P < 0.05). Combination of surfactant lavage with both CV and AHFJV was beneficial in rabbits with meconium aspiration syndrome. While AHFJV was more effective in the removal of meconium, CV had a more favorable effect on lung function in the postlavage period.

Topics: Animals; Animals, Newborn; Bronchoalveolar Lavage; Female; High-Frequency Jet Ventilation; Lung; Lung Diseases; Male; Meconium; Models, Animal; Pulmonary Gas Exchange; Pulmonary Surfactants; Rabbits; Respiratory Function Tests; Syndrome; Treatment Outcome

Loose anagen hair syndrome is a recently described hair disorder. We report a familial case.. Two sisters were examined, 4 years-old and 8 months old, from a consanguineous marriage. At birth, they presented diffuse alopecia of the scalp; the meconium contained black and silky hair. Clinical examination noted the short, fine hair with easy and painless uprooting. No clinical associated symptoms were observed. The trichogram showed 70 p. 100 of anagen hair and 30 p. 100 of telogen hairs.. Our familial case is original by this clinical symptom: discharge of probably dystrophic foetal hair in the meconium. Loose anagen hair is characterised by easily pluckable hair. The trichogram confirms the diagnostic. It is composed of anagen hairs (80 to 100 p. 100) devoid of sheaths. The loose anagen hair is usually isolated, but associations have been reported. It may occur in families. The precise pathogenesis and treatment of this hair disorder are not known.

Topics: Alopecia; Child, Preschool; Female; Hair; Hair Diseases; Humans; Infant; Meconium; Pedigree; Syndrome

Topics: Abnormalities, Multiple; Colon; Humans; Infant, Newborn; Male; Meconium; Mesoderm; Neural Tube Defects; Notochord; Pancreas; Peritonitis; Radiography; Syndrome

Topics: Abdominal Pain; Adolescent; Cystic Fibrosis; Female; Humans; Intestinal Obstruction; Meconium; Radiography; Syndrome

Abdominal plain films of 133 neonates, with 82 cases of meconium plug syndrome (MPS), 27 cases of meconium ileus (MI) and 24 cases of neonatal Hirschsprung's disease (HD), were reviewed to assess the value of such radiographs for diagnosis. The radiographs were examined according to a list of 11 parameters. By using multivariate discriminant analysis, it appeared that 4 parameters i.e. dilatation of bowel loops, varying loop calibre, fluid levels and colonic gas were most important in discriminating among the three disorders. For each parameter the weight (in points) was derived. To classify patients, three group-scores had to be calculated: the group-score with the largest value indicated the most likely disorder. So in 99%, 88% and 63% of MPS, HD and MI, respectively, an accurate diagnosis could be predicted. The overall diagnostic accuracy was 89%. Such a diagnosis can be a sound basis for further investigation.

Topics: Dilatation, Pathologic; Female; Hirschsprung Disease; Humans; Infant, Newborn; Intestinal Obstruction; Male; Meconium; Radiography; Syndrome

A 1-year prospective survey of obstetric and pediatric management of meconium staining of the amniotic fluid in 464 patients was undertaken. Pharyngeal suctioning before delivery was performed using bulb syringe (N = 130), De Lee suction catheter (N = 186), or both (N = 98); endotracheal intubation after delivery was also done in 413 instances. Using any of the three suctioning techniques, no differences were seen in Apgar scores, respiratory rates, presence or absence of meconium on or below the vocal cords, or development of meconium aspiration syndrome (MAS). If meconium was present on the vocal cords, it was present below the vocal cords in 76% of the cases. If no meconium was visualized, it was found below the vocal cords in only 7% of the cases. Of the 142 infants with meconium below the vocal cords, 10% developed MAS and all 14 survived.

Topics: Amniotic Fluid; Delivery, Obstetric; Female; Humans; Infant, Newborn; Intubation, Intratracheal; Male; Meconium; Meconium Aspiration Syndrome; Prospective Studies; Suction; Syndrome; Vocal Cords

Plasma concentrations of immunoreactive human atrial natriuretic peptide (human ANP) were sequentially determined in 12 infants with respiratory distress syndrome (RDS) or meconium aspiration syndrome (MAS) during various phases of diuresis to elucidate the role of human ANP in the occurrence of spontaneous diuresis in the newborn. Plasma immunoreactive ANP concentrations during the diuretic as well as the maximum diuretic phase were significantly (p less than 0.001) higher than during the prediuretic phase. A gradual decrease occurred during the post diuretic phase, returning to prediuretic values after one week of life. Significant natriuresis, increased glomerular filtration rate, mild hyponatremia, and decreased blood pressure were observed in the diuretic phase in all the cases studied. These results suggest that hypersecretion of human ANP may play an important part in initiating spontaneous diuresis in sick neonates.

Topics: Atrial Natriuretic Factor; Diuresis; Female; Humans; Infant, Newborn; Kidney; Male; Meconium; Pneumonia, Aspiration; Respiratory Distress Syndrome, Newborn; Syndrome; Urine

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

This report describes a term gestation abdominal pregnancy resulting in meconium aspiration syndrome (MAS) complicated by pulmonary hypertension. These cases occur infrequently. In this instance, extracorporeal membrane oxygenation (ECMO) was successfully utilized to support the infant after conventional neonatal medical support failed to yield sufficient oxygenation.

Topics: Adult; Extracorporeal Circulation; Female; Humans; Hypertension, Pulmonary; Infant, Newborn; Meconium; Oxygenators, Membrane; Pneumonia, Aspiration; Pregnancy; Pregnancy, Abdominal; Syndrome

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

Two cases are reported of patients in the third trimester of pregnancy in whom routine ultrasound examination revealed progressive dilatation of the fetal intestines. Intestinal obstruction was suspected and amniocentesis as well as amniography with Urografin were done. In both cases a regression in dilatation of bowel was noted on ultrasonography. The Urografin swallowed by the fetus was deemed to have relieved the obstruction of the fetal intestine. The babies were delivered in good condition and passed large amounts of watery meconium per rectum. In spite of the risks inherent in the use of Urografin amniography, as well as of amniocentesis, there appear to be a great number of advantages to the treatment of meconium obstruction of the fetus in utero.

Topics: Adult; Amniocentesis; Amniotic Fluid; Diatrizoate; Diatrizoate Meglumine; Evaluation Studies as Topic; Female; Fetal Diseases; Humans; Infant, Newborn; Intestinal Obstruction; Meconium; Pregnancy; Prenatal Diagnosis; Radiography; Risk; Syndrome; Ultrasonography

Topics: Amniotic Fluid; Asphyxia Neonatorum; Female; Humans; Infant, Newborn; Male; Meconium; Pneumonia, Aspiration; Pregnancy; Respiratory Insufficiency; Syndrome

Topics: Female; Humans; Infant, Newborn; Inhalation; Male; Meconium; Respiration; Retrospective Studies; Syndrome

Topics: Female; Fetal Diseases; Humans; Hyaline Membrane Disease; Infant, Newborn; Inhalation; Lung Diseases; Male; Meconium; Pneumonia, Aspiration; Pregnancy; Respiration; Syndrome

Topics: Humans; Infant, Newborn; Inhalation; Male; Meconium; Mediastinal Emphysema; Syndrome

Topics: Animals; Blood Pressure; Carbon Dioxide; Disease Models, Animal; Extracorporeal Circulation; Female; Fetal Blood; Fetus; Heart-Lung Machine; Inhalation; Lung; Lung Compliance; Meconium; Oxygen; Partial Pressure; Pregnancy; Sheep; Syndrome

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

Topics: Adult; Delivery, Obstetric; Female; Humans; Infant, Newborn; Inhalation; Meconium; Mediastinal Emphysema; Obstetric Labor Complications; Pneumothorax; Pregnancy; Radiography; Syndrome

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

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

Review of the newborn nursery notes of 87 infants who had cystic fibrosis without meconium ileus (MI) indicated that 12 of them had clinical features consistent with the meconium plug syndrome (MPS). This high incidence of meconium abnormalities suggests that MI and the MPS probably represent different gradations of the same underlying pathologic abnormality. The findings further suggest that a quantitative pilocarpine iontophoresis sweat test be performed in every newborn infant with any type of meconium abnormality, including the spontaneous passage of meconium plugs.

Topics: Child, Preschool; Cystic Fibrosis; Humans; Infant; Infant, Newborn; Intestinal Diseases; Intestinal Obstruction; Meconium; Pilocarpine; Sweat; Syndrome

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

Aspiration of meconium by the fetus at or near delivery may be associated with high infant morbidity and mortality. The meconium aspiration syndrome (MAS) is often preventable, yet cases of MAS continue to occur. This paper describes the pathophysiology of MAS. The development of MAS involves passage of meconium by a compromised fetus and the subsequent aspiration of that meconium. Respiratory tract obstruction, hypoxia, hypercapnia, and acidosis may all result. Treatment of MAS is primarily supportive, and high mortality rates have been reported with the more severe cases. There is good evidence that careful suctioning of the infant's upper respiratory tract can in most cases prevent MAS. The suctioning, performed while the infant's head is still on the mother's perineum and prior to the first inspirations, is both a safe and effective preventive procedure.

Topics: Airway Obstruction; Female; Fetal Hypoxia; Fetus; Gastrointestinal Motility; Humans; Infant, Newborn; Meconium; Pneumonia, Aspiration; Pregnancy; Respiratory Insufficiency; Respiratory System; Suction; Syndrome

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

Eleven cases of neonatal intestinal obstruction associated with a white ileal meconium plug are described; 6 of these presented with complications--such as, giant meconium pseudocyst, perforation, volvulus, or atresia. Most of these complications are presumed to have arisen during the intrauterine period. Only one patient could be relieved of the ileal meconium plug by enemas. The condition of ileal meconium plug is not as benign as a meconium plug in the rectum or distal colon. A plea is made to restrict the name meconium plug syndrome to cases in which the meconium plug is white and chalky and the consequent intestinal obstruction can be relieved by enemas, without evidence of intestinal dysfunction in later life.

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

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

Topics: Female; Humans; Infant, Newborn; Inhalation; Meconium; Pregnancy; Respiration; Syndrome

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: Female; Fetal Diseases; Humans; Infant, Newborn; Meconium; Pregnancy; Syndrome

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

One year's experience with MAS in a neonatal intensive-care unit is analyzed with follow-up information. Seventeen patients or 3.7% of all admissions had MAS. Four patients (23.5%) died of acute respiratory failure. Two patients with MAS and persistence of the fetal circulation required cardiac catheterization to exclude cyanotic congenital heart disease. No survivors had persistent chronic lung disease. However, two of three patients with MAS and seizures had significant psychomotor retardation at follow-up examination.

Topics: Amniotic Fluid; Developmental Disabilities; Female; Follow-Up Studies; Humans; Infant; Infant, Newborn; Inhalation; Meconium; Oxygen Inhalation Therapy; Pneumonia, Aspiration; Pregnancy; Prognosis; Radiography; Respiratory Distress Syndrome, Newborn; Syndrome

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

Topics: Adult; Cesarean Section; Female; Humans; Infant, Newborn; Inhalation; Meconium; Pregnancy; Respiration; Respiratory Insufficiency; Suction; Syndrome

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

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

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

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

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

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

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

Dysmaturity, diagnosed according to the Clifford criteria, was studied for the first time in a black population. The infants and matched control subjects were participants in the Collaborative Perinatal Study in Philadelphia from birth to 7 years of age. The incidence of dysmaturity was 25/1,000 live births; more boys than girls were born dysmature, reversing the normal male/female ratio found among black infants in the Collaborative Study as a whole. The condition was more common among post-term infants but did occur in earlier gestational weeks. The overall characteristics of the condition among this black population did not differ from those previously reported among white populations of various races. Surviving infants developed mentally and physically as well as control subjects. No prenatal or environmental characteristics were found that distinguished mothers of dysmature infants from those of nondysmature infants.

Topics: Apgar Score; Bilirubin; Black People; Child; Child, Preschool; Female; Follow-Up Studies; Gestational Age; Hematocrit; Humans; Infant; Infant, Newborn; Infant, Postmature; Infant, Small for Gestational Age; Male; Maternal Age; Meconium; Parity; Pennsylvania; Placenta; Placenta Diseases; Pregnancy; Psychological Tests; Skin Diseases; Syndrome; Vernix Caseosa

The roentgenographic presentations of 11 newborn infants with hypoxemia secondary to pulmonary vasospasm and subsequent right-to-left shunting of blood through the foramen ovale and/or ductus arteriosus (persistent fetal circulation) are described (P. F. C. Syndrome). One infant had radiographically normal lungs, while ten had pulmonary parenchymal abnormalities including hyaline membrane disease [4], meconium aspiration syndrome [4], or an ill defined pattern of retained lung fluid [2]. The roentgenographic appearance of the lungs, however, was discordant with the severe hypoxemia observed in most. Heart size was variable but some degree of cardiomegaly was commonly present. Tolazoline, a potent vasodilator, was useful diagnostically and may have resulted in increased survival. An expanded clinical and roentgeonographic concept of the PFC syndrome is suggested.

Topics: Female; Humans; Hyaline Membrane Disease; Hypertension, Pulmonary; Hypoxia; Infant, Newborn; Male; Meconium; Pneumonia, Aspiration; Radiography; Syndrome; Truncus Arteriosus, Persistent

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

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

Thirty dated pregnant Srague-Dawley rats received IM MgSO4 (750 mg/kg/ X 5 days) until birth. Fifteen untreated pregnant Sprague-Dawley rats of similar gestation served as controls. A total of 453 rats were born. Ninety neonates (two from each of 45 liters) were randomly removed before suckling, sacrificed, and the water content of the meconium and serum magnesium determined. The remaining 363 bewborn rats were observed for delayed passage of meconium or abdominal distention. Hypermagnesemic (6.3 +/- 0.5 mg/100 ml) neonates had neither abdominal distention nor delayed passage of meconium. The water content of meconium in hypermagnesemic rats (84.7 +/- 4.2% and in untreated controls (85.5 +/- 3.8%) were statistically similar. Dated pregnant mongrel dogs were given magnesium sulfate by continuous intravenous infusion and by bolus intravenous injection. The water content of meconium, transit time, and basic electrical rhythm (BER) of treated neonates were similar to untreated neonatal controls. The water content of meconium, transit time, and BER of neonatal dogs made hypermagnesemic (12.0 +/- 1.2 mg/100 ml) in the postnatal period were similar tp untreated neonatal controls. In adult and newborn pupies, receiving a continuous intravenous magnesium sulfate infusion, deep tendon reflexes ceased at serum magnesium levels of 9.0-10.0 mg/100 ml, spontaneous respiration at 14.0-15.0 mg/100 ml, and BER was suppressed (transiently) at 20.0-25.0 mg/10 ml. These data suggest that high (sublethal) doses of MgSO4 in pregnant and newborn animals have little effect on BER, meconium transit time or water content of the neonates. No correlation between MgSO4 treatment and the meconium plug syndrome was observed in the experiments.

Topics: Animals; Animals, Newborn; Colonic Diseases; Dogs; Female; Intestinal Obstruction; Magnesium; Meconium; Pregnancy; Pregnancy Complications; Rats; Syndrome

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

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 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

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

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: Abetalipoproteinemia; Celiac Disease; Child; Cystic Fibrosis; Food Hypersensitivity; Glutens; Humans; Infant; Infant, Newborn; Intestinal Absorption; Intestinal Obstruction; Lipid Metabolism; Lipoproteins; Meconium; Povidone; Starch; Syndrome; Terminology as Topic