Meconium Plug Syndrome (MPS)

Meconium plug syndrome is a transient large bowel obstruction in the newborn relieved by passage of a meconium plug, sometimes with contrast enema or rectal stimulation, and is distinct from meconium ileus.

Meconium plug syndrome was first described by William Clatworthy at Ohio State in 1956 in a report of nine children, one of whom developed or was found to have Hirschsprung disease.

In a 2008 retrospective study over 13 years (1994–2007), 77 newborns were documented to have meconium plug syndrome, and 10 of those babies were subsequently found to have Hirschsprung disease (approximately 13%).

In the 2008 study, no baby with meconium plug syndrome had cystic fibrosis, despite some early literature suggesting an association between cystic fibrosis and meconium plug syndrome.

The 2008 study concluded that babies with meconium plug syndrome and abnormal stooling pattern should undergo rectal biopsy.

A 2024 paper by Dr. Lautz and colleagues at Northwestern, published in the Journal of Pediatric Surgery, was a PHIS database study from 50 US children's hospitals over two years that found 373 newborns with meconium plug syndrome.

The 2024 PHIS database study had limitations including lack of a good code to identify rectal biopsies, requiring use of multiple CPT codes and procedures and diagnostic codes that may make analysis murky.

One center's practice is to perform rectal biopsy if there is abnormal stooling pattern, but not to biopsy every baby with meconium plug syndrome.

One center biopsies all babies with meconium plug syndrome.