Objective: Meconium peritonitis is a chemical peritonitis caused by fetal intestinal perforation before birth. Serious neonatal morbidity or even mortality can occur if the diagnosis is not made until after birth. Prenatal diagnosis is crucial in early postnatal surgical intervention, and so improving perinatal outcome.
Material and Methods: Twenty-two cases diagnosed in utero with meconium peritonitis from January 1996 to December 2008 were enrolled in this study. The final diagnoses were established by surgical findings or postnatal radiography. The antenatal sonographic features, neonatal birth characteristics, surgical findings, postnatal management and neonatal outcomes were reviewed.
Results: All infants reviewed follow-up care at our hospital. Antenatal sonographic findings included fetal ascites (100%), intra-abdominal calcification (95%), dilated bowel loops (55%), pseudocysts (27%), and polyhydramnios (50%). Four infants (18.1%) did not undergo postnatal surgery, but survival 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). Two infants (9 %) died because of sepsis and short bowel syndrome after postnatal operations. The overall surgical rate was 90.9%.
Conclusion: Meconium peritonitis can be diagnosed by antenatal ultrasound, and the neonatal outcome is favorable. Early detection is not associated with poor neonatal outcome, and selective termination is not recommended. Resolution of dilated bowel loops and polyhydramnios predict a low rate of postnatal surgical intervention.