Meconium plug syndrome may result from Hirschsprung disease or cystic fibrosis.
Typically, newborns have feeding problems, vomit, have an enlarged abdomen, and do not have a bowel movement during the first day or two of life.
The diagnosis is based on symptoms and x-ray results.
The blockage is treated with enemas and sometimes surgery.
Meconium, a dark green material, is a newborn's first stool. Newborns expel meconium at or shortly after birth. If the meconium is abnormally thick or tarlike, it can block the large intestine (colon). In meconium plug syndrome, the colon is completely blocked with thick meconium. Above the blockage, the small intestine is enlarged (dilated) resulting in abdominal swelling (distention).
Meconium plug syndrome usually occurs in infants who are otherwise healthy, but it is more common among premature infants Preterm (Premature) Newborns A preterm newborn is a baby delivered before 37 weeks of gestation. Depending on when they are born, preterm newborns have underdeveloped organs, which may not be ready to function outside of... read more , infants born to diabetic mothers, and infants of mothers who were given magnesium sulfate to treat preeclampsia Preeclampsia and Eclampsia Preeclampsia is new high blood pressure or worsening of existing high blood pressure that is accompanied by excess protein in the urine and that develops after the 20th week of pregnancy. Eclampsia... read more , eclampsia Preeclampsia and Eclampsia Preeclampsia is new high blood pressure or worsening of existing high blood pressure that is accompanied by excess protein in the urine and that develops after the 20th week of pregnancy. Eclampsia... read more , or preterm labor Preterm Labor Labor that occurs before 37 weeks of pregnancy is considered preterm. Babies born prematurely can have serious health problems. The diagnosis of preterm labor is usually obvious. Measures such... read more .
Meconium plug syndrome may be a sign of other disorders, such as Hirschsprung disease Hirschsprung Disease Hirschsprung disease is a birth defect in which a section of the large intestine is missing the nerve network that controls the intestine's rhythmic contractions. Symptoms of intestinal obstruction... read more or cystic fibrosis Cystic Fibrosis (CF) Cystic fibrosis is a hereditary disease that causes certain glands to produce abnormally thick secretions, resulting in tissue and organ damage, especially in the lungs and the digestive tract... read more . Meconium ileus Meconium Ileus Meconium ileus is blockage of the small intestine in a newborn caused by excessively thick intestinal contents (meconium), usually as a result of cystic fibrosis. Meconium ileus usually results... read more is similar to meconium plug syndrome except that it is the small intestine that is blocked by meconium.
Symptoms of Meconium Plug Syndrome
After birth, newborns usually pass meconium in the first 12 to 24 hours. However, newborns with meconium plug syndrome do not pass meconium within the first day or two and also have symptoms of intestinal blockage, including vomiting and abdominal swelling. Doctors may feel enlarged loops of small bowel through the abdominal wall.
Diagnosis of Meconium Plug Syndrome
Plain x-rays of the abdomen
Radiopaque contrast enema
Sometimes testing for Hirschsprung disease
Doctors suspect meconium plug syndrome in newborns who have symptoms of blockage and do not pass meconium within the first day or two. Plain x-rays of the abdomen may show intestinal obstruction. To make a definitive diagnosis, doctors take x-rays after giving an enema using a liquid substance that is visible on x-rays (radiopaque contrast agent X-rays with a radiopaque contrast agent X-rays are high-energy radiation waves that can penetrate most substances (to varying degrees). In very low doses, x-rays are used to produce images that help doctors diagnose disease. In high... read more ). The contrast agent outlines the inside of the colon and allows doctors to see the meconium plug.
Infants who have meconium plug syndrome are often tested for Hirschsprung disease Diagnosis Hirschsprung disease is a birth defect in which a section of the large intestine is missing the nerve network that controls the intestine's rhythmic contractions. Symptoms of intestinal obstruction... read more and for cystic fibrosis Diagnosis Cystic fibrosis is a hereditary disease that causes certain glands to produce abnormally thick secretions, resulting in tissue and organ damage, especially in the lungs and the digestive tract... read more .
Treatment of Meconium Plug Syndrome
Radiopaque contrast enema
Rarely surgery
The radiopaque contrast enema is used to help diagnose and treat meconium plug syndrome. The contrast liquid helps bring fluid into the colon and break off the meconium so that the infant can then pass the meconium.
If the enema does not remove the plug, doctors may remove it surgically.
