FETAL MECONIUM PERITONITIS: ULTRASOUND DIAGNOSIS AND OUTCOMES
- Authors: Mashinets N.V.1, Demidov V.N.1
-
Affiliations:
- Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia
- Issue: No 11 (2015)
- Pages: 110-116
- Section: Articles
- URL: https://journals.eco-vector.com/0300-9092/article/view/247574
- ID: 247574
Cite item
Open Access
Access granted
Abstract
Objective. To study the significance of different echographic intrauterine signs of meconium peritonitis in determining the severity of the disease and final prognosis for a neonatal infant. Subjects and methods. Thirty-four cases of meconium peritonitis diagnosed at 22-38 weeks’ gestation were analyzed. Results. The accuracy of ultrasound diagnosis was 100%>. The main echographic signs of this abnormality were hyperechogenic adhesive mass; thickening of the intestinal wall and its increased echogenicity; calcifications in the abdominal and thoracic cavities and scrotum; dilated intestinal loops; the presence of pseudocysts; ascites, adhesions, and serous fluid collection. After birth, 62.5% of the babies needed surgical treatment. Postoperative neonatal survival was 95%. Conclusion. Meconium cyst, ascites with adhesions, dilated intestinal loops with the hyperechogenic and thickened wall are the most important echographic signs necessitating postnatal surgery.
Keywords
Full Text
About the authors
Natalya Valerievna Mashinets
Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia
Email: natashamashinets@yandex.ru
PhD, the senior scientific worker of the department of functional diagnostics department of diagnostic imaging Moscow 117997, Ac. Oparina str. 4, Russia
Vladimir Nikolaevich Demidov
Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia
Email: v_demidov@oparina4.ru
MD, professor of the department of functional diagnostics department of diagnostic imaging. Moscow 117997, Ac. Oparina str. 4, Russia
References
- Мерц Э. Ультразвуковая диагностика в акушерстве и гинекологии. Акушерство. Пер. с англ. Гус А.И., ред. М.: МЕДпресс-информ, 2011; т.1: 348. [Merz Е. Ultrasound diagnosis in obstetrics and gynecology. Obstetrics. Trans, from English. Gus A., ed. Moscow: MEDpress-inform, 2011; vol.l: 348. (in Russian)]
- Медведев M.B., Сыпченко E.B., Гусева О.И. Желудочно-кишечный тракт. В кн.: Медведев М.В., ред. Пренатальная эхография. М.: Реальное Время; 2005: 439-83.
- Foster M.A., NybergD.A., Mahony B.S., MackL.A., Marks W.M., Raabe R.D. Meconium peritonitis: prenatal sonographic findings and their clinical significance. Radiology. 1987; 165(3): 661-5.
- Hertzberg B.S., Kliewer M.A., Bowie J.D. Эхографическое обследование желудочно-кишечной системы плода. В кн.: Флейшер А., Мэнинг Ф., Дженти П., Ромеро Р., ред. Эхография в акушерстве и гинекологии. Теория и практика. Пер. с англ. 6-е изд. М.: Видар-М; 2005; ч.І: 445-68.
- Hatzmann W., Dieckgieber U., Dieckgieber A. Ultrasonografische diagnose eines fatalen Ascites mit Polyhydramnion infolge partieller Dunudar marte- sie und sekundarer Darmwandperforation. Ultrashall.1984; 5(1): 144-7.
- Young D. G., Wilkinson A. W. Abnormalities associated with neonatal duodenal obstruction. Surgery. 1968; 63(5): 832-6.
- Гусева О.И. Перинатальные исходы при врожденных пороках развития. Мекониевый перитонит. Пренатальная диагностика. 2004; 3(1): 21-8.
- Гусева О.И. Ультразвуковая диагностика врожденных пороков развития желудочно-кишечного тракта: автореф. дисс.. д-ра мед. наук. Нижний Новгород; 2006. 44с.
- Игнатьев E.M. Мекониевый перитонит - диагностика и лечение: автореф. дисс.. канд. мед. наук. СПб.; 2012. 22с.
- Valladares E., Rodriguez D., Vela A., Cabre S., Lailla J.M. Meconium pseudocyst secondary to ileum volvulus perforation without peritoneal calcification: a case report. J. Med. Case Rep. 2010; 4: 292.
- Внутриутробный мекониевый перитонит. В кн.: Исаков Ю.Ф., Володин Н.Н., Гераськин А.В., ред. Неонатальная хирургия. М.: Династия; 2011: 572-8.
- Hsu C.H., Jen L.W., Huang F.Y., Chen M.R., Kao H.A., Ho WY et al. Clinical observation of meconium peritonitis. Zhonghua Min Guo Xiao Er Ke YiXue Hui Za Zhi. 1990; 31(4): 214-20.
- Piazza A.J., Stoll B.J. Meconium ileus in cystic fibrosis. In: Kliegman R.M., Behrman R.E., Jenson H.B., Stanton B.F., eds. Nelson Textbook of pediatrics. 18th ed. Philadelphia: Saunders Elsevier; 2007: 754.
- Zangheri G., Andreani M., Ciriello E., Urban G., Incerti M., Vergani P. Fetal intra-abdominal calcifications from meconium peritonitis: sonographic predictors of postnatal surgery. Prenat. Diagn. 2007; 27(10): 960-3.
- Tseng J.J., Chou M.M., Ho E.S. Meconium peritonitis in utero: prenatal sonographic findings and clinical implications. J. Chin. Med. Assoc. 2003; 66(6): 355-9.
- Finkel L.I., Slovis T.L. Meconium peritonitis, introperitoneal calcifications and cystic fibrosis. Pediatr. Radiol. 1982; 12(2): 92-3.
- Moreland S.I. 3rd, Cohen M.I., Leopold G.R., Gosink B.B. Third-trimester fetal sonography: meconium simulating a presacral mass. AJR Am. J. Roentgenol. 1988; 150(2): 379-80.
- Estrojf J.A., Bromley B., Benacerraf B.R. Fetal meconium peritonitis without sequelae. Pediatr. Radiol. 1992; 22(4): 277-8.
- Dirkes K., Crombleholme T.M., Craigo S.D., Latchaw L.A., Jacir N.N., Harris B.H., D’Alton M.E. The natural history of meconium peritonitis diagnosed in utero. J. Pediatr. Surg. 1995; 30(7): 979-82.
- Donnison A.B., Shwachman H, Gross R.E. A review of 164 children with meconium ileus seek at the Children’s Hospital Medical Center, Boston. Pediatrics. 1966; 37(5): 833-50.
- SoongJ.H., Hsieh C.C., Chiu TH, Kuo DM, Chen EP, Lo LM., Soong Y.K. Meconium peritonitis - antenatal diagnosis by ultrasound. Changgeng Yi Xue Za Zhi. 1992; 15(3): 155-60.
Supplementary files
