Fetal meconium peritonitis complicated with bacterial infection.
Fetal meconium peritonitis complicated by bacterial infection is extremely rare. We report a case of fetal ascites at 21 weeks of gestation with subsequent development of loculation, encapsulation, and calcification at 25 weeks. Paracentesis of loculated ascitic fluid at 28 weeks of gestation showed a purulent appearance with the presence of cocci bacteria, increase in white cell count, and a low glucose level, which were suggestive of bacterial infection. However, no sources of maternal infection could be identified. The total bilirubin level of the ascitic fluid was normal (21 micromol/L). A healthy baby was delivered at 37 weeks. CT scan revealed normal bowel without any sign of perforation. We postulate that when ascitic fluid becomes loculated, a normal bilirubin level on paracentesis indicates spontaneous closure of a previous bowel perforation.
Yanfang
Zhong
Z
Department of Prenatal Diagnosis, GuangDong Women and Children Hospital and Health Institute, Guangzhou 510010, P. R. China.
Chun
Hong
H
Limin
Wang
W
Li
Zeng
Z
Zhu
Lin
L
Huamei
Huang
H
D000328:Adult; D001202:Ascitic Fluid / Q000382:microbiology; D001424:Bacterial Infections / Q000150:complications / Q000196:embryology / Q000382:microbiology*; D003937:Diagnosis, Differential; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging / Q000382:microbiology*; D005865:Gestational Age; D006801:Humans; D008470:Meconium / Q000382:microbiology*; D010538:Peritonitis / Q000000981:diagnostic imaging / Q000382:microbiology*; D011247:Pregnancy; D014057:Tomography, X-Ray Computed; D016216:Ultrasonography, Prenatal / Q000379:methods