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KMID : 0358420100530020119
Korean Journal of Obstetrics and Gynecology
2010 Volume.53 No. 2 p.119 ~ p.126
Meconium peritonitis: prenatal diagnosis and postnatal outcome
Kang Byung-Hun

Nor Heung-Tae
Rhee Yun-Ee
Lee Ki-Hwan
Ko Young-Bok
Yang Jung-Bo
Lee Kyung-Eun
Lee Kun-Woo
Lee Min-A
Abstract
Objective: To detect meconium peritonitis for the fetal period is important for prenatal counseling. The aim of this study was to evaluate prenatal ultrasound finding for diagnosing meconium peritonitis and postnatal clinical course and outcomes.

Methods: The prenatal and postnatal medical records of all patients to our institutions with confirmed meconium peritonitis were reviewed, with emphasis on prenatal ultrasound findings, postnatal investigations, operative findings, outcomes of meconium peritonitis.

Results: Fourteen fetuses were confirmed to have meconium peritonitis at birth by operation. Eight cases were diagnosed correctly because of prenatal ultrasound showing ascites and calcification/dilated or hyperechoic bowel loops. In the other 6 cases, prenatal ultrasound showed only ascites. One patient was operated on first day of life and its intra-operative finding was malrotation of small bowel, volvulus with strangulation, perforation and jejunal atresia. Most cases were operated on 2nd or 3rd day of life. Intra-operative findings were ileal atresia and perforation in 11 cases and jejunal atresia and perforation in 3 cases. Four patients underwent ileostomy but all patients survived and prospered.

Conclusion: All patients do not present typical prenatal ultrasound findings of meconium peritonitis. Therefore, even in pregnancies associated with isolated ascites, meconium peritonitis should be taken into consideration. Favorable outcome of intrauterine meconium peritonitis is reassuring in prenatal counselling and stems from multidisplinary team approach.
KEYWORD
Meconium peritonitis, Ultrasonography, Prenatal diagnosis, Outcome
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