WHEN A FETUS AFFECTED BY INTESTINAL OBSTRUCTION SUDDENLY SHOWS THE PRESENCE OF ASCITES OR GENERALIZED HYDROPS, ONE SHOULD SUSPECT

• A. An abdominal teratoma
• B. Gallbladder calcifications
• C. Meconium peritonitis ✓
• D. Intestinal infarction

Meconium peritonitis is a condition that can occur in utero when there is perforation of the bowel in the fetus, leading to the leakage of meconium into the peritoneal cavity. This condition can present with various signs and symptoms, one of which is the presence of ascites or generalized hydrops.

Signs and Symptoms of Meconium Peritonitis:

• Ascites: The accumulation of fluid in the peritoneal cavity can lead to abdominal distension, which may be detected during prenatal ultrasound examinations.
• Generalized Hydrops: This refers to the abnormal accumulation of fluid in two or more fetal compartments, such as pleural effusion, pericardial effusion, and ascites. It is a severe manifestation of fetal compromise.

Diagnostic Considerations: When a fetus affected by intestinal obstruction suddenly shows the presence of ascites or generalized hydrops, healthcare providers should consider meconium peritonitis as a possible underlying cause. Meconium peritonitis can result from various etiologies, including intrauterine bowel perforation due to conditions like cystic fibrosis, meconium ileus, or volvulus.

Management and Prognosis: The management of meconium peritonitis in utero involves close monitoring of fetal well-being and potential interventions to address complications such as bowel obstruction. In some cases, surgical intervention may be necessary after birth to repair the bowel perforation.

In conclusion, when encountering a fetus with intestinal obstruction presenting with ascites or generalized hydrops on imaging studies, healthcare providers should consider meconium peritonitis as a potential diagnosis that warrants further evaluation and management.