Meconium obstruction of prematurity in tiny babies - towards developing an international consensus

Intestinal perforation occurring in extremely low gestational age neonates is a devastating complication, associated with high mortality and morbidity. Multiple phenotypes of bowel perforation in premature infants have been described, with the most common being spontaneous, or isolated, intestinal perforation and perforated necrotizing enterocolitis. The purpose of this article is to summarize literature describing "meconium obstruction of prematurity", increasingly recognized as a distinct clinical phenotype in the smallest and most immature neonates. The goal of this review is to improve international recognition and understanding of this high-risk clinical condition. The lack of standardized nomenclature has been an obstacle to progress in understanding, preventing, and treating this important and more frequently encountered condition. The recognition of meconium obstruction requiring medical or surgical management is a clear distinguishing factor from other bowel pathologies of prematurity.