Meconium peritonitis in utero

To clarify the relationship between clinical features in utero and postnata l prognosis, 20 fetuses who underwent ultrasonic (US) evaluation for meconi um peritonitis (MP) over a 17-year period were reviewed. According to final US findings in utero, patients were classified into three types. Type I (m assive meconium ascites) was noted is 5 cases, type II (giant pseudocyst) i n 4, and the other 11 were classified as type III (calcification and/or sma ll pseudocyst). Abdominal calcifications were identified in only 5 cases (2 type I, 1 type II, 2 type III). Seven fetuses who had associated polyhydra mnios (1 Type I, 1 Type II, 2 Type III) and fetal hydrops (3 Type II) were delivered before 36 weeks' gestation. Cardiopulmonary resuscitation at birt h was required in 9 cases (5 type I, 4 type II) who underwent abdominal dra inage before delivery and/or immediately after birth. Although dilatation o f the intestine was identified in 10 fetuses (2 type II, 8 Type III), is ha d intestinal atresia and 2 had fecal obstruction of the distal ileum. Four infants (2 type I, 1 type II, 1 type III) died of respiratory failure and p ostoperative complications. These results indicated that careful fetal US m ay be useful for perinatal management of MP.