Using prenatal MRI to define features of meconium peritonitis: an overall outcome

To use prenatal magnetic resonance imaging (MRI) to define features of meconium peritonitis (MP) and analyse the relationship between prenatal MRI findings and postnatal outcomes.

Eight cases were enrolled who had been diagnosed with MP through prenatal MRI; the diagnoses were confirmed at surgery and pathology or follow-up. MP was diagnosed by the findings of meconium ascites, meconium pseudocyst, or dilated bowel loops. Prenatal follow-up after diagnosis by MRI was performed by ultrasound.

Prenatal MRI findings included massive meconium ascites (five out of eight cases), a small meconium pseudocyst (one out of eight), a large meconium pseudocyst along with a dilated bowel loop (one out of eight), a dilated bowel loop alone (one out of eight), and micro-colorectum (six out of eight). Six fetuses showed abdominal distension, bilious vomiting, and no normal meconium at birth; they underwent exploratory laparotomies and subsequently, survived and prospered. Only one fetus (with a small meconium pseudocyst) received conservative treatment. There was one mortality, and the cause of death was full-bowel necrosis.

Prenatal MRI may be helpful for diagnosing MP, in cases where the specific MRI findings are persistent meconium ascites, a dilated bowel loop, micro-colorectum, and meconium pseudocyst. In particular, a micro-colorectum might indirectly reflect ileum atresia, which requires postnatal surgery.