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Licensed Unlicensed Requires Authentication Published by De Gruyter June 3, 2009

Prenatal diagnosis and postnatal management of meconium peritonitis

  • Nadia Saleh , Annegret Geipel , Ulrich Gembruch , Axel Heep , Andreas Heydweiller , Peter Bartmann , Axel R. Franz and Andreas Müller

Abstract

Background: Meconium peritonitis (MP) is a rare prenatal condition that leads to substantial neonatal morbidity and mortality.

Patients and methods: All patients between 1998 and 2006 referred for prenatal diagnosis were retrospectively analyzed for diagnosis of MP. Prenatal ultrasound findings were compared with postnatal etiology, intraoperative findings, and postnatal outcome of the patients.

Results: Antenatal MP was diagnosed in 14 fetuses between 18 and 38 weeks' gestation. The prenatal diagnosis of MP was confirmed by clinical and radiological findings in 8 (62%) of 13 infants born alive. All patients were delivered preterm between 33 and 36 weeks' gestation by cesarean section. Urgent neonatal surgery for treatment of bowel obstruction was required in all eight infants. Prenatal ultrasound diagnosis of bowel dilatation was the only variable found to be associated with the need for subsequent surgical intervention (P=0.02).

Conclusions: Clinical outcome of MP diagnosed antenatally can be either mild or severe form. The underlying cause of severe MP is heterogeneous and neonatal surgery was always required.


Corresponding author: PD Dr. Andreas Müller Department of Neonatology Children's Hospital University of Bonn Adenauerallee 119 D-53113 Bonn Germany Tel.: +49-228-287-15449 Fax: +49-228-287-16291

Received: 2008-12-2
Revised: 2009-3-4
Accepted: 2009-4-3
Published Online: 2009-06-03
Published Online: 2009-06-03
Published in Print: 2009-09-01

©2009 by Walter de Gruyter Berlin New York

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