Taiwanese Journal of Obstetrics and Gynecology
Volume 47, Issue 4 , Pages 391-396, December 2008

Meconium Peritonitis In Utero—the Value of Prenatal Diagnosis in Determining Neonatal Outcome

  • Chao-Nin Wang

      Affiliations

    • Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
    • Chang Gung University College of Medicine, Taoyuan, Taiwan
    • ,
  • Shuenn-Dyh Chang

      Affiliations

    • Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
    • Chang Gung University College of Medicine, Taoyuan, Taiwan
    • ,
  • An-Shine Chao

      Affiliations

    • Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
    • Chang Gung University College of Medicine, Taoyuan, Taiwan
    • ,
  • Tzu-Hao Wang

      Affiliations

    • Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
    • Chang Gung University College of Medicine, Taoyuan, Taiwan
    • ,
  • Ling-Hong Tseng

      Affiliations

    • Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
    • Chang Gung University College of Medicine, Taoyuan, Taiwan
    • ,
  • Yao-Lung Chang

      Affiliations

    • Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
    • Chang Gung University College of Medicine, Taoyuan, Taiwan
    • Corresponding Author InformationCorrespondence to Dr Yao-Lung Chang, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Linkou Medical Center, No. 5, Fu-Shin Street, Kweishan, Taoyuan, Taiwan

Accepted 27 August 2007.

Article Outline

SUMMARY 

Objective

Meconium peritonitis (MP) is a chemical peritonitis caused by fetal intestinal perforation in utero. Its incidence is rare, but serious neonatal morbidity or even mortality can occur if the diagnosis is not made until after birth. Prenatal diagnosis is important in prompting early postnatal surgical intervention, and so improving neonatal outcome.

Materials and Methods

Fourteen cases diagnosed in utero with MP from January 1996 to December 2005 were enrolled in this study. The final diagnoses were established by surgical findings or postnatal radiography. The prenatal ultrasound features, neonatal birth characteristics, surgical findings, postnatal management and neonatal outcomes were reviewed.

Results

All infants received follow-up care at our hospital. Prenatal ultrasound findings included fetal ascites (100%), intra-abdominal calcification (93%), dilated bowel loops (57%), pseudocysts (29%), and polyhydramnios (50%). Four infants (4/14; 28.5%) did not undergo postnatal surgery, but survived well. The mean gestational age at detection was significantly earlier in the non-surgery group (23 ± 3.6 weeks) than in the surgery group (31.7 ± 2.5 weeks). One infant (7.1%) died because of sepsis after two neonatal operations. The overall survival rate was 92.9%.

Conclusion

MP can be diagnosed by prenatal ultrasound, and the neonatal outcome is favorable. Early detection is not associated with poor neonatal outcome, and selective termination is unnecessary. Resolution of dilated bowel loops and polyhydramnios predict a low rate of postnatal surgical intervention.

Key Words:  calcification , fetal ascites , meconium peritonitis , prenatal ultrasound , pseudocyst

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PII: S1028-4559(09)60004-8

doi:10.1016/S1028-4559(09)60004-8

Taiwanese Journal of Obstetrics and Gynecology
Volume 47, Issue 4 , Pages 391-396, December 2008

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