Prevención de la obstrucción meconial en recién nacidos prematuros de muy bajo peso / Prevention of meconium obstruction in very low birth weight preterm infants

Introducción: El retraso en la expulsión de meconio es una causa de obstrucción intestinal en el recién nacido (RN) extremadamente prematuro (< 28 SEG) con un peso inferior a 1.500 g al nacimiento. Objetivo: Evaluar la eficacia del tratamiento conservador en la prevención de la obstrucción meconial en RN prematuros de muy bajo peso. Método: Estudio descriptivo y retrospectivo realizado en la Unidad de Cuidados Intensivos Neonatales de un hospital de nivel terciario. Se incluyó a todos los RN prematuros extremos de bajo peso que nacieron durante el periodo del estudio, desde agosto del 2016 hasta enero del 2017, y que presentaban obstrucción meconial. Resultados: Se obtuvo una muestra de 42 RN. Respecto a la expulsión de meconio, un 57,1% de la muestra expulsó meconio de forma espontánea, mientras que un 42,9% recibió los diferentes tratamientos conservadores. De estos, un 72,2% fueron tratados con enemas de suero fisiológico. Del 27,8% restante, un 16% con enemas de N-acetilcisteína, 16% con Gastrografin(R) y ninguno precisó tratamiento quirúrgico. Conclusión: El tratamiento conservador parece ser una medida terapéutica efectiva para la prevención de la obstrucción meconial en los RN prematuros de muy bajo peso, ya que logró la expulsión de meconio sin tener que aplicar tratamiento quirúrgico

Introduction: Delayed meconium expulsion is a cause of bowel obstruction in the extremely premature newborn (< 28 WGE) weighing less than 1500 g at birth. Objective: To evaluate the efficacy of conservative treatment in the prevention of meconium obstruction in very-low-birt- weight preterm infants. Method: Descriptive and retrospective study performed at the Neonatal Intensive Care Unit of a tertiary level hospital. All very-low-birth-weight preterm infants who were born during the study period, from August 2016 to January 2017, and who had meconium obstruction were included. Results: A sample of 42 newborn infants was obtained. Regarding the expulsion of meconium, 57.1% of the sample spontaneously ejected meconium, while 42.9% received different treatments. Of these, 72.2% were treated with saline enemas, 16% with acetylcysteine enemas, 16% with Gastrografin(R) and none required surgical treatment. Conclusion: Conservative treatment seems to be an effective therapeutic measure for the prevention of meconium obstruction in very-low-birth-weight preterm infants since it achieved the expulsion of meconium without having to apply surgical treatment

Prevention of meconium obstruction in very low birth weight preterm infants. / Prevención de la obstrucción meconial en recién nacidos prematuros de muy bajo peso.

INTRODUCTION: Delayed meconium expulsion is a cause of bowel obstruction in the extremely premature newborn (<28 WGE) weighing less than 1500g at birth. OBJECTIVE: To evaluate the efficacy of conservative treatment in the prevention of meconium obstruction in very-low-birt- weight preterm infants. METHOD: Descriptive and retrospective study performed at the Neonatal Intensive Care Unit of a tertiary level hospital. All very-low-birth-weight preterm infants who were born during the study period, from August 2016 to January 2017, and who had meconium obstruction were included. RESULTS: A sample of 42 newborn infants was obtained. Regarding the expulsion of meconium, 57.1% of the sample spontaneously ejected meconium, while 42.9% received different treatments. Of these, 72.2% were treated with saline enemas, 16% with acetylcysteine enemas, 16% with Gastrografin® and none required surgical treatment. CONCLUSION: Conservative treatment seems to be an effective therapeutic measure for the prevention of meconium obstruction in very-low-birth-weight preterm infants since it achieved the expulsion of meconium without having to apply surgical treatment.