关键词: 胎儿, 产前诊断, 围产期, 临床管理, 治疗, 预后

Abstract:

Cystic meconium peritonitis (CMP), type Ⅱ complex meconium peritonitis, is a pseudocyst wrapping the leakage and partial intestinal loop with the fibrous tissue caused by meconium stimulation due to long-term unsealed fetal intestinal perforation. Prenatal ultrasound is the main method of diagnosing CMP, and CMP is characterized by the irregular shape of pseudocyst wall and uneven internal echo inside in the abdominal cavity, with calcification strong echo within or on the pseudocyst wall. The intestinal tract may be enveloped. Since magnetic resonance imaging (MRI) can more directly show the location and extent of the diseased intestinal segment, it helps to distinguish the anatomical location between abdominal cyst and intestinal tract. With certain advantages, MRI can be used for the diagnosis of complex CMP and the differential diagnosis of other cystic lesions in the abdominal cavity. Intrauterine genetics and viral infection-related prenatal diagnosis are recommended for the pregnant women with the CMP and high-risk factors. The isolated CMP requires the dynamic monitoring, including maternal and fetal general conditions, fetal growth and development, as well as changes in pseudocyst. Fetal abdominal paracentesis and cyst fluid aspiration treatment can relieve symptoms and prolong gestational age if necessary. The delivery pattern should be determined, based on the obstetric indications of the mother and fetus, combined with the wishes of the pregnant woman′s family and multidisciplinary collaborative treatment conditions. Newborn with CMP should be treated with surgery as soon as possible, paying attention to postoperative complications and long-term intestinal function recovery. Patients who need parenteral nutrition should be followed up for long-term prognosis, and intestinal transplantation may be considered if necessary.

Key words: Fetus, Prenatal diagnosis, Peripartum period, Clinical governance, Therapy, Prognosis