Prenatal diagnosis and postnatal management of meconium peritonitis.
BACKGROUND
Meconium peritonitis (MP) is a rare prenatal condition that leads to substantial neonatal morbidity and mortality.


METHODS
All patients between 1998 and 2006 referred for prenatal diagnosis were retrospectively analyzed for diagnosis of MP. Prenatal ultrasound findings were compared with postnatal etiology, intraoperative findings, and postnatal outcome of the patients.


RESULTS
Antenatal MP was diagnosed in 14 fetuses between 18 and 38 weeks' gestation. The prenatal diagnosis of MP was confirmed by clinical and radiological findings in 8 (62%) of 13 infants born alive. All patients were delivered preterm between 33 and 36 weeks' gestation by cesarean section. Urgent neonatal surgery for treatment of bowel obstruction was required in all eight infants. Prenatal ultrasound diagnosis of bowel dilatation was the only variable found to be associated with the need for subsequent surgical intervention (P=0.02).


CONCLUSIONS
Clinical outcome of MP diagnosed antenatally can be either mild or severe form. The underlying cause of severe MP is heterogeneous and neonatal surgery was always required.
Saleh
Nadia
N
Department of Neonatology, Children's Hospital, University of Bonn, Germany.
Geipel
Annegret
A
Gembruch
Ulrich
U
Heep
Axel
A
Heydweiller
Andreas
A
Bartmann
Peter
P
Franz
Axel R
AR
Müller
Andreas
A
D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008470:Meconium; D010538:Peritonitis / Q000000981:diagnostic imaging* / Q000601:surgery*; D011247:Pregnancy; D012189:Retrospective Studies; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal