Fetal Meconium Peritonitis: A Clinical Study of Nine Cases

Abstract

Objective. To explore the prenatal ultrasonographic characteristics and pregnancy outcomes of fetal meconium peritonitis (FMP). Methods. Nine patients diagnosed with FMP by routine prenatal examination between January 2015 and December 2020 were identified. Both prenatal ultrasonographic characteristics and pregnancy outcomes associated with these patients were retrospectively analyzed. Results. The mean gestational age at the time of FMP diagnosis was 31.3 ± 4.8 weeks, and the mean gestational age of delivery was 35.1 ± 5.1 weeks. Prenatal ultrasonographic findings at the time of diagnosis in these patients included intestinal dilatation (9/9, 100%), intraperitoneal calcification (8/9, 88.9%), fetal ascites (5/9, 55.6%), intraperitoneal pseudocyst (5/9, 55.6%), and polyhydramnios (6/9, 66.7%). Analyses of the etiological basis for meconium peritonitis in 5 of the 8 live births that underwent surgical treatment revealed 4 cases of congenital volvulus and 1 case of jejunal atresia. Conclusion. The prenatal ultrasound manifestations of fetal meconium peritonitis are diverse, and the different grades of prenatal ultrasound manifestations can provide important information for the treatment of perinatal infants.

Fetal Abdominal Cyst as a Stage of Meconium Peritonitis after Fetoscopic Laser Photocoagulation

“…The most common ultrasonographic findings include bowel dilatation, intraabdominal calcification, ascites, intraperitoneal pseudocyst, and polyhydramnios. 5,6,10,[14][15][16] Our case is quite unusual because of its unusual course starting from ascites and hyperechoic bowel, presenting further with intraperitoneal pseudocyst with intestinal connection, intraperitoneal calcifications, dilated aperistaltic bowel loops, and polyhydramnion. Pseudocyst was not seen later; a possible explanation is the formation of intestinal fistula.…”

“…The most common ultrasonographic findings include bowel dilatation, intraabdominal calcification, ascites, intraperitoneal pseudocyst, and polyhydramnios. 5 6 10 14 15 16…”

“…1,2 Fetal meconium peritonitis (FMP) is a rare form of sterile chemical peritonitis that can occur in utero due to the perforation of the fetal intestine with the broad spectrum of prenatal ultrasound manifestations. [3][4][5] Understanding of FMP ultrasound presentation and evolution is crucial for the management.…”

Fetal Appendiceal Perforation Masquerading as Meconium Peritonitis: A Report of a Rare Case

“…Wang et al reported two similar cases where antenatal monitoring of dimensions and observations of distension and ileus led to suspicion of meconium peritonitis [ 1 ]. Antenatal diagnosis of meconium peritonitis is now possible with improved imaging techniques such as prenatal graded compression ultrasound, which is highly accurate, aiding in early diagnosis and providing crucial information; however, its sensitivity varies and relies heavily on the operator's skill [ 7 ]. Abdominal X-rays in various positions (supine, upright, and lateral) are usually insufficient for identifying intraperitoneal free gas.…”

Intra-Uterine Perforation Presented as a Giant Cystic Abdominal Mass in a Neonate: A Giant Meconium Pseudocyst

“…During post-natal diagnosis, occasionally, an abdominal roentgenogram reveals large egg-shell calcification in the case of a long-standing meconium pseudocyst. In Fu et al [ 8 ], the average gestational age for diagnosis of fetal meconium peritonitis was found to be 31.3 ± 4.8 weeks, and the ultrasound revealed intestinal dilation (most common), intraperitoneal calcification, fetal ascites, and intraperitoneal pseudocysts, and polyhydramnios. Some studies claimed that fetal MRI has better diagnostic accuracy between 51% and 73.4% for a fetus with an abdominal cystic lesion and, thus, aids in counseling and planning delivery setting.…”