Fetal meconium peritonitis in the infant of a woman with fulminant hepatitis B. A case report.
BACKGROUND
Simultaneous fulminant maternal hepatitis B infection and fetal meconium peritonitis has never been reported before in the English-language literature.


METHODS
Fetal meconium peritonitis was detected at 32 weeks' gestation in a 21-year-old woman suffering from fulminant hepatitis. Fulminant hepatitis B was confirmed by clinical observation and serologic examination results. The course was also complicated with preterm labor. The fetus was diagnosed with meconium peritonitis prenatally. Because of failed tocolytic treatment, the fetus was delivered vaginally. Both the mother and fetus received intensive care, and the mother recovered. In contrast, the fetus's course worsened due to progressive abdominal distension. Although exploratory laparotomy was attempted, the operation was not successful. The infant died five days after birth.


CONCLUSIONS
Recognition of the predisposing factors in fetal meconium peritonitis and immediate referral to a tertiary medical center, where specialists are available, could help physicians determine an accurate diagnosis and might improve prognosis.
Su
Weng-Hsiang
WH
Department of Obstetrics and Gynecology, Toayuang Yee-Zen General Hospital, No. 30, Lane 321, Yang-Hsin North Road, Yang-Mei, Toa-Yuang, 326, Taiwan. solson@tpts5.seed.net.tw
Wang
Peng-Hui
PH
Yuan
Chiou-Chung
CC
Chang
Sheng-Ping
SP
D000328:Adult; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006509:Hepatitis B / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D007231:Infant, Newborn; D017093:Liver Failure / Q000150:complications / Q000175:diagnosis*; D008470:Meconium; D007752:Obstetric Labor, Premature; D010538:Peritonitis / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*; D011263:Pregnancy Trimester, Third; D011859:Radiography; D016216:Ultrasonography, Prenatal