Analysis of the clinical diagnosis and treatment of fetal meconium peritonitis

Abstract

Background

The purpose of this study was to improve diagnostic and therapeutic standards by examining the clinical features, treatment, and prognosis of fetal meconium peritonitis (FMP), as well as the diagnostic efficacy of ultrasound for FMP.

Methods

The clinical data of 41 infants and pregnant women diagnosed with meconium peritonitis (MP) and treated at the Fujian Maternal and Child Health Hospital from January 2013 to January 2020 were analyzed retrospectively. Clinical data, imaging data, complications, treatment strategies, pregnancy outcomes, neonatal prognoses, and follow-up outcomes were all analyzed.

Results

The MP prenatal diagnosis rate was 56.1% (23/41), the neonatal surgery rate was 53.7% (22/41), and the survival rate was 85.4% (35/41). Intraperitoneal calcification (23 pregnant women, 56.1%), intestinal dilatation (13 pregnant women, 31.7%), peritoneal effusion (22 pregnant women, 53.7%), intraperitoneal pseudocyst (7 pregnant women, 17.1%), and polyhydramnios were diagnosed via prenatal ultrasound (18 pregnant women, 43.9%). Twenty-two pregnant women were assigned to the surgical treatment (operation) group, while 18 were assigned to the conservative treatment group. In the operation group, there were 9 cases of ileal atresia (40.9%), 7 cases of jejunal atresia (31.8%), 2 cases of atresia at the jejunum-ileum junction (9.1%), 2 cases of ileal perforation (9.1%), 1 case of ileal necrosis (4.5%), and 1 case of adhesive obstruction (4.5%). There was no statistically significant difference (p > .05) in the occurrence of various prenatal ultrasound findings by etiology.

Conclusion

Multiple prenatal ultrasound markers have been identified for MP. To improve the efficacy of newborn treatment for FMP and reduce neonatal mortality, dynamic monitoring of ultrasound image alterations and strengthened integrated perinatal management are necessary.

Keywords:

• Meconium peritonitis
• diagnosis
• prognosis
• treatment
• ultrasound

Acknowledgments

We would like to acknowledge the hard and dedicated work of all the staff that implemented the intervention and evaluation components of the study.

Ethical approval

I confirm that I have read the Editorial Policy pages. This study was conducted with approval from the Ethics Committee of Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University. This study was conducted in accordance with the declaration of Helsinki. Written informed consent was obtained from all participants’ guardian.

Authors contributions

ZXQ and WDM conceived the idea and conceptualized the study. CX, LJX and WXC collected the data and analyzed the data. RKH, LHQ and YJY drafted the manuscript, then ZXQ and XRL reviewed the manuscript. All authors read and approved the final draft.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The datasets used and/or analyzed during the current study available from the corresponding author on reasonable request.

Additional information

Funding

This study was funded by Guide Fund for the Development of Local Science and Technology from the Central Government (2020L3019); Joint Funds for the innovation of science and Technology, Fujian province (2020Y9134); Fujian Provincial Health Technology Project (2021CXA034); National Health and Family Planning Commission Science Foundation (2019-WJ-04); Health research project of Department of Finance (Fujian finance refers to [2019] No. 827) (2020Y183); The Natural Science Foundation of Fujian Province Project (2023J011220); Innovation Platform Project of Science and Technology, Fujian province (2021Y2012); National Key Clinical Specialty Construction Program of China (Obstetric). The funding bodies had no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.