Meconium peritonitis in utero.
To clarify the relationship between clinical features in utero and postnatal prognosis, 20 fetuses who underwent ultrasonic (US) evaluation for meconium peritonitis (MP) over a 17-year period were reviewed. According to final US findings in utero, patients were classified into three types. Type I (massive meconium ascites) was noted is 5 cases, type II (giant pseudocyst) in 4, and the other 11 were classified as type III (calcification and/or small pseudocyst). Abdominal calcifications were identified in only 5 cases (2 type I, 1 type II, 2 type III). Seven fetuses who had associated polyhydramnios (1 Type I, 1 Type II, 2 Type III) and fetal hydrops (3 Type II) were delivered before 36 weeks' gestation. Cardiopulmonary resuscitation at birth was required in 9 cases (5 type I, 4 type II) who underwent abdominal drainage before delivery and/or immediately after birth. Although dilatation of the intestine was identified in 10 fetuses (2 type II, 8 Type III), 18 had intestinal atresia and 2 had fecal obstruction of the distal ileum. Four infants (2 type I, 1 type II, 1 type III) died of respiratory failure and postoperative complications. These results indicated that careful fetal US may be useful for perinatal management of MP.
Kamata
S
S
Department of Pediatric Surgery, Osaka University Medical School, Suita, Japan.
Nose
K
K
Ishikawa
S
S
Usui
N
N
Sawai
T
T
Kitayama
Y
Y
Okuyama
H
H
Imura
K
K
Okada
A
A
D001201:Ascites / Q000145:classification / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D002114:Calcinosis / Q000145:classification / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D002423:Cause of Death; D003560:Cysts / Q000145:classification / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D005260:Female; D005315:Fetal Diseases / Q000145:classification / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007415:Intestinal Obstruction / Q000209:etiology; D008297:Male; D008471:Meconium Aspiration Syndrome / Q000145:classification / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D010538:Peritonitis / Q000145:classification / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D011247:Pregnancy; D011256:Pregnancy Outcome; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D016216:Ultrasonography, Prenatal