[Prenatal sonographic diagnosis and clinical consequences in small intestine obstruction]

Fetal intestinal obstructions can be diagnosed and differentiated from other intra-abdominal lesions with prenatal sonography. The characteristic signs are persistent echo-free areas in the fetal abdomen which frequently show peristaltic movements, and the accompanying polyhydramnios. A vaginal delivery near term is desirable and tocolytic agents and therapeutic amniocentesis should be used in the event of premature labour and maternal distress due to polyhydramnios. Premature labour also necessitates the induction of pulmonary maturation with corticoids. At least weekly ultrasonic controls are advisable to detect the rare bowel perforation. In the case of an intestinal rupture, the risk of prematurity must be weighed against the risk of abacterial meconium peritonitis before labour is induced. Own observations in five prenatally diagnosed intestinal obstructions and a review of the literature confirm the proposed management in these infants.