Meconium obstruction in the markedly premature infant

Greenholz, Stephen K.; Pérez, Carlos Manuel Montaño; Wesley, John R.; Marr, Clifford C.

doi:10.1016/s0022-3468(96)90332-2

Cited by 40 publications

(45 citation statements)

References 16 publications

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“…However in this study, the procedure-related bowel perforation itself developed only in 3 cases (9.1% on per-patient basis), and the possibility of perforation seems to be relatively low as compared with the previous reports of spontaneous perforation rate in untreated MO (about 30%) [2,24]. Compared with the previous reports about the Gastrografin ® enema for the MO under US or fluoroscopic guidance, perforation rate of our study noted higher, because none of them reported about the perforation during the procedure [10,25].…”

Section: Discussioncontrasting

confidence: 71%

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Ultrasound-guided contrast enema for meconium obstruction in very low birth weight infants: Factors that affect treatment success

Cho

Cheon

Choi

et al. 2015

European Journal of Radiology

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Section: Discussioncontrasting

confidence: 71%

“…After the removal of the meconium,bowel distention improved. fetal hypermagnesemia, and prematurity itself [1,3,18,[24][25][26][27]. These causes included any condition causing hypoperfusion or dysmotility of the bowel loops which can cause meconium stasis.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided contrast enema for meconium obstruction in very low birth weight infants: Factors that affect treatment success

Cho

Cheon

Choi

et al. 2015

European Journal of Radiology

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“…The therapeutic aim of these enemas is in general to decrease meconium viscosity with saline solution (NaCl 0.9%) (11,19) or with osmotic agents such as Gastrografin (16) or iopamidol (29). Such approaches have been associated with complications like dehydration (34), intestinal perforation, or rectal injury (1,7,10,18). However, it remains unclear whether these complications result from the procedure by itself or are a primary consequence of colon dysfunctions due to immaturity.…”

Section: Discussionmentioning

confidence: 99%

Butyrate enemas enhance both cholinergic and nitrergic phenotype of myenteric neurons and neuromuscular transmission in newborn rat colon

Suply

Vries

Soret

et al. 2012

American Journal of Physiology-Gastrointestinal and Liver Physi

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Postnatal changes in the enteric nervous system (ENS) are involved in the establishment of colonic motility. In adult rats, butyrate induced neuroplastic changes in the ENS, leading to enhanced colonic motility. Whether butyrate can induce similar changes during the postnatal period remains unknown. Enemas (Na-butyrate) were performed daily in rat pups between postnatal day (PND) 7 and PND 17. Effects of butyrate were evaluated on morphological and histological parameters in the distal colon at PND 21. The neurochemical phenotype of colonic submucosal and myenteric neurons was analyzed using antibodies against Hu, choline acetyltransferase (ChAT), and neuronal nitric oxide synthase (nNOS). Colonic motility and neuromuscular transmission was assessed in vivo and ex vivo. Butyrate (2.5 mM) enemas had no impact on pup growth and histological parameters compared with control. Butyrate did not modify the number of Hu-immunoreactive (IR) neurons per ganglia. A significant increase in the proportion (per Hu-IR neurons) of nNOS-IR myenteric and submucosal neurons and ChAT-IR myenteric neurons was observed in the distal colon after butyrate enemas compared with control. In addition, butyrate induced a significant increase in both nitrergic and cholinergic components of the neuromuscular transmission compared with control. Finally, butyrate increased distal colonic transit time compared with control. We concluded that butyrate enemas induced neuroplastic changes in myenteric and submucosal neurons, leading to changes in gastrointestinal functions. Our results support exploration of butyrate as potential therapy for motility disorders in preterm infants with delayed maturation of the ENS.

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“…In previous studies, maternal hypertension, oligohydramnios or chronic placenta abruption were reported as resulting in perinatal intestinal hypoperfusion, which in turn resulted in dysmotility of the gastrointestinal tract [10,11] . It has also been suggested that maternal diabetes leads to fetal hypoglycemia and increases the level of glucagon, which decreases fetal bowel motility [12] .…”

Section: Discussionmentioning

confidence: 99%

Recognition, Diagnosis and Treatment of Meconium Obstruction in Extremely Low Birth Weight Infants

Kim

et al. 2011

Neonatology

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Background: Meconium obstruction (MO) of prematurity can result in increased morbidity or mortality and prolonged hospitalization if not diagnosed and treated appropriately. Objectives: The aims of our study were to identify the incidence and risk factors associated with MO and to review the treatment outcomes. Methods: A retrospective analysis was undertaken of 101 extremely low birth weight infants (ELBWIs) who were born between January 1, 2007, and April 1, 2009, at Seoul National University Hospital. Prenatal and neonatal factors were compared between the MO and control groups. The treatment outcomes were also reviewed. Results: Twenty-two (22%) patients were diagnosed as having MO. Eighteen of these patients (82%) had prenatal risk factors for MO. Respiratory distress syndrome was more prevalent in the MO group than in the control group (p = 0.001). Overall, 17 of the 22 patients (77%) were relieved with medical treatment and the rest underwent ileostomy. The times to full enteral feeding did not differ between the medically treated group and the control group. However, the surgically treated group required more time to achieve full enteral feeding, and some patients had persistent gastrointestinal problems. Conclusion: MO is not a rare condition in ELBWIs, and the majority of ELBWIs have prenatal risk factors. Medical management was effective, and medically manageable cases had good prognoses for subsequent feeding, whereas some surgically managed cases had persistent gastrointestinal problems.

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Meconium obstruction in the markedly premature infant

Cited by 40 publications

References 16 publications

Ultrasound-guided contrast enema for meconium obstruction in very low birth weight infants: Factors that affect treatment success

Ultrasound-guided contrast enema for meconium obstruction in very low birth weight infants: Factors that affect treatment success

Butyrate enemas enhance both cholinergic and nitrergic phenotype of myenteric neurons and neuromuscular transmission in newborn rat colon

Recognition, Diagnosis and Treatment of Meconium Obstruction in Extremely Low Birth Weight Infants

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