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Vernix Caseosa Peritonitis: A Scoping Review.

Goran Augustin1, Mislav Herman2,3, Zrinka Hrgović4,5

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Medicina (Kaunas, Lithuania)
|October 29, 2025
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Summary
This summary is machine-generated.

Vernix caseosa peritonitis (VCP) is a rare postpartum complication, often diagnosed late. Early recognition of abdominal pain, fever, and dyspnea is key, with surgical lavage as the primary treatment.

Keywords:
corticosteroidsdiagnosisoutcomessystematic reviewtreatmentvernix caseosa peritonitis

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Area of Science:

  • Obstetrics and Gynecology
  • Surgical Pathology
  • Perinatal Medicine

Background:

  • Vernix caseosa peritonitis (VCP) is a rare condition presenting with nonspecific abdominal symptoms in the early puerperium.
  • Preoperative diagnosis of VCP is challenging due to overlapping symptoms with other acute abdominal conditions.
  • Identifying risk factors and optimizing diagnosis and treatment are crucial for improving maternal outcomes.

Purpose of the Study:

  • To identify risk factors associated with Vernix caseosa peritonitis (VCP).
  • To evaluate early diagnostic methods and treatment strategies for VCP.
  • To analyze the relationship between diagnostic timing, disease severity, and maternal outcomes in VCP cases.

Main Methods:

  • A systematic literature review was conducted using PubMed, PubMed Central, and Google Scholar, adhering to PRISMA guidelines.
  • Search terms included various combinations of 'vernix caseosa peritonitis', 'maternal meconium peritonitis', 'puerperium', and 'postpartum'.
  • Data extracted included demographic, clinical, obstetric, diagnostic, treatment parameters, and maternal/neonatal outcomes from 46 case reports.

Main Results:

  • VCP predominantly affects term pregnancies, with 87% delivered via Cesarean section (CS).
  • Common symptoms include abdominal pain and fever (>38 °C), with dyspnea/tachypnea being frequent (23.9%/15.2%).
  • Preoperative diagnosis was rare (4.3%), intraoperative diagnosis occurred in 60.9%, and histopathology confirmed VCP in 89.1%; no maternal or neonatal deaths were reported.

Conclusions:

  • Vernix caseosa peritonitis (VCP) primarily occurs in term pregnancies, often following Cesarean section, without identifiable additional risk factors.
  • Despite diagnostic delays, VCP has no reported maternal or fetal mortality, with surgical lavage being the main treatment.
  • Abdominal pain, fever, and dyspnea in early puerperium warrant consideration for VCP, with corticosteroids potentially beneficial and antibiotics having limited utility.