Pränatale Diagnose einer fetalen Mekoniumperitonitis, Therapie und Verlauf

Abstract

We report on the prenatal diagnosis of a case of foetal meconium peritonitis pursuant to colon perforation in the 34th week of gestation. A sonographic examination of the foetus showed ascites, dense zones around the peritoneum and intestine, hepatosplenomegaly and hydroceles, as well as a slight hydramnios. The foetal abdomen was punctured under ultrasonographic control, and ascitic fluid was withdrawn. It was sterile but included granulocytes, leucocytes, epidermal epithelial cells and lanugo hairs, thereby confirming the diagnosis. The bilirubin concentration was very high, and the protein content was also increased. An amniofoetography gave a clear picture of the small intestine and showed a calcified zone in the upper left abdomen. A Caesarean section was performed prior to term, and the prenatal diagnosis was confirmed. After surgical correction the infant has developed satisfactorily up to the present age of 15 months, even though mucoviscidosis was diagnosed at the age of 5 months. In addition to ascites due to meconium peritonitis, several other types of foetal ascites are discussed.