Prenatal diagnosis of meconium peritonitis in a twin pregnancy after intracytoplasmic sperm injection. A case report.
BACKGROUND
Meconium peritonitis occurring in pregnancies following artificial reproductive techniques (ART) is rare. We report the first case of meconium peritonitis following intracytoplasmic sperm injection (ICSI).


METHODS
A 37-year-old woman attended our in vitro fertilization (IVF) program because her husband suffered from hypospermatogenetic azoospermia due to cancer surgery and radiotherapy. The patient achieved a twin pregnancy through ICSI from testicular sperm extraction at our IVF center. Meconium peritonitis, fetal ascites, polyhydramnios, bowel dilatation, hydrocele and intraabdominal calcification were noted in one of the twins on ultrasound at 30 weeks' gestation. Cesarean section due to breech presentation in labor was performed at 36 weeks' gestation. A normal female and male infant with a distended abdomen were delivered. Emergency laparotomy was performed on the male twin because of dyspnea. A 0.2-cm perforation was found in the terminal ileum. Ileotomy was performed and closed after 27 days.


CONCLUSIONS
Prenatal diagnosis of meconium peritonitis is possible through careful ultrasonographic examination, and early surgical intervention and intensive postoperative support are required to improve the prognosis.
Seow
K M
KM
Department of Obstetrics and Gynecology, Shin Kong Wu Ho-Su Memorial Hospital, No. 95, Wen Chang Road, Shin Lin District, Taipei, Taiwan, R.O.C.
Cheng
W C
WC
Yeh
M L
ML
Hwang
J L
JL
Tsai
Y L
YL
D000328:Adult; D001946:Breech Presentation; D002585:Cesarean Section; D004200:Diseases in Twins / Q000209:etiology*; D005260:Female; D006801:Humans; D007082:Ileum / Q000293:injuries*; D007231:Infant, Newborn; D007416:Intestinal Perforation / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000601:surgery; D008297:Male; D008470:Meconium; D009845:Oligospermia / Q000209:etiology / Q000628:therapy; D010538:Peritonitis / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000601:surgery; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D011379:Prognosis; D020554:Sperm Injections, Intracytoplasmic / Q000009:adverse effects*; D016216:Ultrasonography, Prenatal / Q000379:methods*