title: Meconium Peritonitis: Correlation of Antenatal Diagnosis and Postnatal Outcome - An Institutional Experience over 10 Years.
abstract: OBJECTIVE
  To identify the fetal and neonatal imaging characteristics of meconium peritonitis (MP) and their clinical outcome. We also studied the role of prenatal ultrasound (US) in antenatal diagnosis and its use in predicting the need for surgical intervention postnatally.
  
  
  METHODS
  We conducted a retrospective analysis of a cohort of 18 infants with MP from April 2004 to March 2014.
  
  
  RESULTS
  Prenatal US detected MP-related abnormalities in 15/18 (83.3%) fetuses. The median gestational age at initial diagnosis of MP was 24 weeks (range 19-31). Fetal ascites (93.3%) was the most common prenatal US finding. Of the 18 infants, 12 (66.7%) required surgical intervention. The overall survival rate was 94.4%. All infants with a prenatal US scan showing meconium pseudocyst or bowel dilatation required surgical intervention postnatally.
  
  
  CONCLUSIONS
  A combination of ascites, intraperitoneal calcification, and echogenic bowel on fetal US raises a high suspicion of MP. Surgical intervention is indicated in the presence of meconium pseudocyst on fetal or postnatal US scan. Antenatal US has high specificity (100%) but low sensitivity (22.2%) in detecting meconium pseudocyst. A favorable outcome can be expected with early antenatal diagnosis and timely surgical intervention in a tertiary hospital.
authors.affiliation: Department of Neonatology, KK Women's and Children's Hospital, Singapore, Singapore.
authors.forename: Lee May
authors.initials: LM
authors.lastname: Ping
authors.forename: Victor Samuel
authors.initials: VS
authors.lastname: Rajadurai
authors.forename: Seyed Ehsan
authors.initials: SE
authors.lastname: Saffari
authors.forename: Suresh
authors.initials: S
authors.lastname: Chandran
mesh_terms: D001201:Ascites / Q000000981:diagnostic imaging / Q000196:embryology / Q000209:etiology / Q000517:prevention & control; D015331:Cohort Studies; D003131:Combined Modality Therapy / Q000009:adverse effects; D004065:Digestive System Abnormalities / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007416:Intestinal Perforation / Q000503:physiopathology* / Q000601:surgery; D007421:Intestine, Small / Q000002:abnormalities* / Q000601:surgery; D008297:Male; D008470:Meconium; D010538:Peritonitis / Q000000981:diagnostic imaging* / Q000196:embryology / Q000453:epidemiology / Q000209:etiology; D011183:Postoperative Complications / Q000517:prevention & control; D011247:Pregnancy; D011379:Prognosis; D012189:Retrospective Studies; D012846:Singapore / Q000453:epidemiology; D016019:Survival Analysis; D016216:Ultrasonography, Prenatal
keywords: Fetal ascites; Fetal ultrasonography; Intraperitoneal calcification; Meconium peritonitis; Meconium pseudocyst