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Meconium peritonitis in stillbirths.

D L Yavner1, J M Lage

  • 1Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts 02115.

Pediatric Pathology
|January 1, 1988
PubMed
Summary

Meconium peritonitis, a rare condition in stillbirths, was identified in three fetuses via autopsy. Intrauterine hypoxia may contribute to this sterile peritonitis caused by fetal bowel perforation.

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Area of Science:

  • Perinatology
  • Pathology
  • Fetal Medicine

Background:

  • Meconium peritonitis is a sterile chemical peritonitis caused by fetal bowel perforation.
  • It is exceptionally rare in stillbirths, making autopsy findings crucial for diagnosis.

Observation:

  • Autopsy of three fetuses (21-39 weeks gestation) revealed meconium peritonitis.
  • Clinical histories suggested potential fetal hypoxia in two cases; one fetus was hydropic with abdominal calcifications.
  • Autopsy revealed meconium in the peritoneal cavity, adhesions, and serosal nodules in two fetuses; calcified meconium nodules were the sole indicator in the third.

Findings:

  • Meconium peritonitis was confirmed in three fetuses, with varying autopsy evidence.
  • Microscopic calcified meconium nodules were diagnostic in one case.
  • Antecedent fetal bowel perforation may be evidenced solely by meconium peritonitis at autopsy.

Implications:

  • This study highlights the rarity and diagnostic challenges of meconium peritonitis in stillbirths.
  • Intrauterine hypoxia is proposed as a potential contributing factor in some cases.
  • Autopsy remains critical for identifying fetal bowel perforation sequelae.

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