Fetal abnormalities » Gastrointestinal tract
Meconium peritonitis
Prevalence:
- 1 in 3,000 births
Ultrasound diagnosis:
- Presence of intra-abdominal hyperechogenic areas (peritoneal calcifications). Results from intrauterine perforation of the bowel which leads to a local sterile chemical peritonitis.
- Additionally: dilated bowel loops, ascites and meconium pseudocyst.
Associated abnormalities:
- The incidence of chromosomal abnormalities and genetic syndroms is not increased.
- Risk of cystic fibrosis: 75%.
Investigations:
- Detailed ultrasound examination.
- Amniocentesis: DNA studies for cystic fibrosis if both parents are carriers.
- TORCH test for fetal infections
Follow up:
- Ultrasound scans every 4 weeks to monitor the evolution of the condition.
Delivery:
- Place: hospital with neonatal intensive care and pediatric surgery.
- Time: 38 weeks.
- Method: induction of labor aiming for vaginal delivery.
Prognosis:
- In case of simple peritonitis the outcome is good and surgical intervention is not necessary.
- In case of complex peritonitis (associated with bowel dilatation, ascites) the prognosis is poor and neonatal mortality is >50%.
Recurrence:
- Isolated: no increased risk of recurrence.