Treatment of meconium peritonitis in the antenatal and postnatal periods during pregnancy and after childbirth (a clinical case)



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Abstract

Introduction. This article describes a clinical case of a pregnant woman with fetal meconium peritonitis and further observation and treatment of the child. Meconium peritonitis, being aseptic intrauterine peritonitis, is a serious disease that requires an integrated approach. Tactics of management the fetus, intrauterine risks and prognosis of survival in this pathology as well as choice of the technique for correcting meconium peritonitis and its complications during pregnancy and after childbirth are discussed.
Material and methods. Prenatal ultrasound examination revealed in a male fetus signs of low intestinal obstruction, distortion of bowel loops, calcifications, ascites and polyhydramnios. This case shows that depending on the clinical course of peritonitis the timely performed diagnostics reduces risks of life-threatening complications.
Results. Due to the newly developed ultrasound criteria which assess the pathology severity (meconium ascites, compression of the fetal chest cavity, edema and polyhydramnios), it became possible to predict the course of meconium peritonitis. Management of pregnancy, childbirth and neonatal period as well as therapeutic and surgical correction of this severe pathology with further early rehabilitation are described in details.
Conclusion. Meconium peritonitis is a pathology in which a timely established prenatal diagnosis is extremely important because it significantly improves prognosis and allows to take adequate steps prenatally for stabilizing the condition of both a fetus and a pregnant woman.

About the authors

F. A. Ovsyannikov

V.A. Almazov National Medical Research Centre

Author for correspondence.
Email: fake@neicon.ru

St. Petersburg, 197341

Russian Federation

N. R. Ryabokon'

V.A. Almazov National Medical Research Centre

Email: sivers1@yandex.ru

Nikita R. Ryabokon', MD, assistant at department of obstetrics and gynecology

St. Petersburg, 197341

Russian Federation

V. G. Bairov

V.A. Almazov National Medical Research Centre

Email: fake@neicon.ru

St. Petersburg, 197341

Russian Federation

A. A. Suhotskaya

V.A. Almazov National Medical Research Centre

Email: fake@neicon.ru

St. Petersburg, 197341

Russian Federation

I. E. Zazerskaya

V.A. Almazov National Medical Research Centre

Email: fake@neicon.ru

St. Petersburg, 197341

Russian Federation

M. V. Korolev

V.A. Almazov National Medical Research Centre

Email: fake@neicon.ru

St. Petersburg, 197341

Russian Federation

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