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Computational Intelligence and... 2022To explore the prenatal ultrasonographic characteristics and pregnancy outcomes of fetal meconium peritonitis (FMP).
OBJECTIVE
To explore the prenatal ultrasonographic characteristics and pregnancy outcomes of fetal meconium peritonitis (FMP).
METHODS
Nine patients diagnosed with FMP by routine prenatal examination between January 2015 and December 2020 were identified. Both prenatal ultrasonographic characteristics and pregnancy outcomes associated with these patients were retrospectively analyzed.
RESULTS
The mean gestational age at the time of FMP diagnosis was 31.3 ± 4.8 weeks, and the mean gestational age of delivery was 35.1 ± 5.1 weeks. Prenatal ultrasonographic findings at the time of diagnosis in these patients included intestinal dilatation (9/9, 100%), intraperitoneal calcification (8/9, 88.9%), fetal ascites (5/9, 55.6%), intraperitoneal pseudocyst (5/9, 55.6%), and polyhydramnios (6/9, 66.7%). Analyses of the etiological basis for meconium peritonitis in 5 of the 8 live births that underwent surgical treatment revealed 4 cases of congenital volvulus and 1 case of jejunal atresia.
CONCLUSION
The prenatal ultrasound manifestations of fetal meconium peritonitis are diverse, and the different grades of prenatal ultrasound manifestations can provide important information for the treatment of perinatal infants.
Topics: Female; Fetal Diseases; Humans; Infant; Infant, Newborn; Meconium; Peritonitis; Pregnancy; Pregnancy Outcome; Retrospective Studies; Ultrasonography, Prenatal
PubMed: 35669660
DOI: 10.1155/2022/8658999 -
Wiadomosci Lekarskie (Warsaw, Poland :... 2022The aim: To analyze the current state of the issue of Hirschsprung disease in newborns and infants on the basis of literature data and first-hand experience. (Review)
Review
OBJECTIVE
The aim: To analyze the current state of the issue of Hirschsprung disease in newborns and infants on the basis of literature data and first-hand experience.
CONCLUSION
Conclusions: 1. Hirschsprung disease should be suspected in all newborns with late meconium passage. 2. The main methods of diagnosing Hirschsprung disease in newborns and infants are the assessment of anamnestic data, clinical manifestations and features of the clinical course of the pathology, contrast enema, morphological examination of rectal biopsies and immunohistochemistry for ACE. 3. The presence of enterocolitis in newborns and infants should raise suspicion of Hirschsprung disease. 4. Low intestinal obstruction, perforation of the cecum, ascending or terminal small intestine, and peritonitis in the first days of a child's life may be complications of Hirschsprung disease. 5. In newborns and infants, early diagnosis of Hirschsprung disease and timely surgical correction by one-stage surgery help improve treatment outcomes.
Topics: Biopsy; Child; Digestive System Surgical Procedures; Enterocolitis; Hirschsprung Disease; Humans; Infant; Infant, Newborn; Intestinal Obstruction
PubMed: 35633338
DOI: 10.36740/WLek202204220 -
Nagoya Journal of Medical Science Feb 2022We reviewed the outcomes of meconium peritonitis and evaluated the safety and feasibility of primary radical surgery for meconium peritonitis. A total of 21 cases of...
We reviewed the outcomes of meconium peritonitis and evaluated the safety and feasibility of primary radical surgery for meconium peritonitis. A total of 21 cases of meconium peritonitis between 2006 and 2020 were retrospectively reviewed. The patients were classified into two groups based on the type of surgery: group I (primary radical surgery, n = 16) and group II (multistage surgery; drainage only or ileostomy, followed by elective surgery, n = 5). Patient backgrounds and surgical outcomes were compared between the two groups. The term of prenatal diagnosis, preoperative white blood cell count, and preoperative catecholamine use were not significantly different between the two groups. Group I included more mature neonates than group II (gestational age at birth, 35w1d vs 30w1d, p = 0.02; birth weight, 2.5 kg vs 1.1 kg, p < 0.01). Preoperative C-reactive protein was significantly lower in group I (0.37 mg/dL vs 2.8 mg/dL, p < 0.05). Operation time, blood loss, time to enteral feeding, and complication rates were not significantly different between the two groups. The surgical outcomes of primary radical surgery were comparable to those of multistage surgery, although the patients' backgrounds were different. Our strategy of selecting one-stage or multiple-stage surgery for treatment of meconium peritonitis, depending on the patient's general condition and degree of intestinal ischemia, was reasonable.
Topics: Feasibility Studies; Female; Gestational Age; Humans; Infant, Newborn; Meconium; Peritonitis; Pregnancy; Retrospective Studies
PubMed: 35392019
DOI: 10.18999/nagjms.84.1.148 -
Indian Journal of Pediatrics Oct 2022Acute abdomen in the fetus can present as nonspecific fetal distress, and occasionally necessitate emergency cesarean section for the mother and subsequent emergency...
Acute abdomen in the fetus can present as nonspecific fetal distress, and occasionally necessitate emergency cesarean section for the mother and subsequent emergency neonatal surgery. Often, preoperative diagnosis in utero is challenging. The authors herein report two cases, a case of primary segmental antenatal intestinal volvulus resulting in the mother presenting at 35 wk with symptoms and decreased fetal movements, and another case of a rapidly distending fetal abdominal mass at 31 wk manifesting as fetal hydrops. The postdelivery newborn management issues are presented. Early identification by the maternal and neonatal team allows for early neonatal surgery and can reduce morbidity and mortality. This can be facilitated by advanced maternal and child health services and efficient patient transport systems.
Topics: Cesarean Section; Child; Emergencies; Female; Fetus; Humans; Infant, Newborn; Pregnancy; Premature Birth; Prenatal Care
PubMed: 35119646
DOI: 10.1007/s12098-022-04091-6 -
Korean Journal of Radiology Jan 2022Gastrointestinal (GI) emergencies in neonates and infants encompass from the beginning to the end of the GI tract. Both congenital and acquired conditions can cause... (Review)
Review
Gastrointestinal (GI) emergencies in neonates and infants encompass from the beginning to the end of the GI tract. Both congenital and acquired conditions can cause various GI emergencies in neonates and infants. Given the overlapping or nonspecific clinical findings of many different neonatal and infantile GI emergencies and the unique characteristics of this age group, appropriate imaging is key to accurate and timely diagnosis while avoiding unnecessary radiation hazard and medical costs. In this paper, we discuss the radiological findings of essential neonatal and infantile GI emergencies, including esophageal atresia and tracheoesophageal fistula, hypertrophic pyloric stenosis, duodenal atresia, malrotation, midgut volvulus for upper GI emergencies, and jejunoileal atresia, meconium ileus, meconium plug syndrome, meconium peritonitis, Hirschsprung disease, anorectal malformation, necrotizing enterocolitis, and intussusception for lower GI emergencies.
Topics: Diagnostic Imaging; Duodenal Obstruction; Humans; Infant; Infant, Newborn; Intestinal Atresia; Intussusception
PubMed: 34983099
DOI: 10.3348/kjr.2021.0111 -
Journal of Pediatric Surgery Aug 2022Meconium peritonitis (MP) is a sterile, chemical peritonitis resulting from in-utero fetal bowel perforation. Severe cases may lead to serious morbidities and... (Review)
Review
BACKGROUND
Meconium peritonitis (MP) is a sterile, chemical peritonitis resulting from in-utero fetal bowel perforation. Severe cases may lead to serious morbidities and mortalities.
OBJECTIVE
To review the common antenatal ultrasound abnormalities associated with MP, and identify radiological and clinical prognostic factors.
MATERIALS AND METHODS
Retrospective review of all neonates with MP from January 1997 to December 2019 treated in our hospital was performed. Antenatal ultrasound findings, clinical presentations and outcomes were analyzed.
RESULTS
Thirty-five neonates (17 males, 18 females) were included in the study. Thirty-two (91.4%) attended antenatal screening, and 27 (84.4%) of them had abnormalities identified on antenatal ultrasound. The most common abnormality was polyhydramnios (43.8%). Nineteen (54.3%) patients were inborn. Twenty (57.1%) patients were born prematurely. Laparotomy was required in 85.7% of patients. The median time to laparotomy was shorter in the inborn group [1 day (0-9 days) vs 4 days (2-34 days), p = 0.001], but the duration of post-operative hospital stay was comparable [71 days (16-423 days) vs 73.5 days (23-231 days)]. However, such duration was found to be significantly longer in the pre-term group when compared to full-term [58.5 days (16-89 days) vs 85 (21-423 days), p = 0.01]. The most common pathology was small bowel atresia and there were two mortalities.
CONCLUSION
Due to the advancement in prenatal detection, pediatric anesthesia, intensive care and surgical techniques, the morbidity and mortality of MP has much decreased. Effective multi-disciplinary antenatal counseling facilitated the perinatal management of MP and resulted in comparable prognosis and outcome in inborn and outborn neonates.
Topics: Child; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Intestinal Atresia; Intestinal Perforation; Male; Meconium; Peritonitis; Pregnancy; Tertiary Care Centers; Ultrasonography, Prenatal
PubMed: 34794810
DOI: 10.1016/j.jpedsurg.2021.10.006 -
Pediatrics International : Official... Aug 2021
Topics: Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Meconium; Peritonitis
PubMed: 34121279
DOI: 10.1111/ped.14518 -
Journal of Surgical Case Reports May 2021Fetal intestinal volvulus is rare, but it is a serious condition due to its life-threatening complications. The bowel loop becomes twisted; thus, impaired venous return...
Fetal intestinal volvulus is rare, but it is a serious condition due to its life-threatening complications. The bowel loop becomes twisted; thus, impaired venous return leads to bowel necrosis. Prenatal volvulus is most secondary to intestinal atresia, arterial supply defect or without any underlying cause, with consideration that cystic fibrosis is the cause of the intestinal obstruction, because of meconium ileus. We report a case of prenatal volvulus complicated with intestinal perforation and meconium peritonitis in the context of meconium ileus.
PubMed: 34055287
DOI: 10.1093/jscr/rjab192 -
Pediatrics and Neonatology Jul 2021
Topics: Female; Fetal Diseases; Fetal Macrosomia; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Male; Meconium; Peritonitis; Pregnancy
PubMed: 33931345
DOI: 10.1016/j.pedneo.2021.03.006 -
Wavy Floating Greater Omentum Findings Are Useful for Differentiating the Etiology of Fetal Ascites.Diagnostics (Basel, Switzerland) Feb 2021The greater omentum is an apron-like peritoneal mesothelial sheet that was described by ultrasound as a floating fluid-filled viscus in ascites during the fetal period....
The greater omentum is an apron-like peritoneal mesothelial sheet that was described by ultrasound as a floating fluid-filled viscus in ascites during the fetal period. To examine the association between the etiology of fetal ascites and ultrasound findings of the greater omentum, a retrospective study was conducted. Ultrasound findings of fetal omentum were defined as follows: (1) a cyst-like shape with a thin membrane observed as wavy in the ascites, (2) beside the stomach and below the liver, and (3) no blood flow noted on color Doppler. Eleven pregnancies had fetal ascites. A fetal greater omentum was confirmed in eight cases in which ascites were caused by non-peritonitis: fetal hydrops ( = 4), congenital cytomegalovirus infection ( = 2), idiopathic chylous ascites ( = 1), and unknown cause ( = 1). Of these eight cases, no abdominal surgical management was required in three live babies. However, a fetal greater omentum was not confirmed in all three cases of meconium peritonitis. It was suggested that the finding of the greater omentum can be an important clue for estimating the pathophysiological etiology of fetal ascites and helping with postnatal management. It should be reasonable to add the finding of the greater omentum to the detailed ultrasound examination checklist.
PubMed: 33671226
DOI: 10.3390/diagnostics11020326