Analysis of the clinical diagnosis and treatment of fetal meconium peritonitis.

BACKGROUND: The purpose of this study was to improve diagnostic and therapeutic standards by examining the clinical features, treatment, and prognosis of fetal meconium peritonitis (FMP), as well as the diagnostic efficacy of ultrasound for FMP. METHODS: The clinical data of 41 infants and pregnant women diagnosed with meconium peritonitis (MP) and treated at the Fujian Maternal and Child Health Hospital from January 2013 to January 2020 were analyzed retrospectively. Clinical data, imaging data, complications, treatment strategies, pregnancy outcomes, neonatal prognoses, and follow-up outcomes were all analyzed. RESULTS: The MP prenatal diagnosis rate was 56.1% (23/41), the neonatal surgery rate was 53.7% (22/41), and the survival rate was 85.4% (35/41). Intraperitoneal calcification (23 pregnant women, 56.1%), intestinal dilatation (13 pregnant women, 31.7%), peritoneal effusion (22 pregnant women, 53.7%), intraperitoneal pseudocyst (7 pregnant women, 17.1%), and polyhydramnios were diagnosed via prenatal ultrasound (18 pregnant women, 43.9%). Twenty-two pregnant women were assigned to the surgical treatment (operation) group, while 18 were assigned to the conservative treatment group. In the operation group, there were 9 cases of ileal atresia (40.9%), 7 cases of jejunal atresia (31.8%), 2 cases of atresia at the jejunum-ileum junction (9.1%), 2 cases of ileal perforation (9.1%), 1 case of ileal necrosis (4.5%), and 1 case of adhesive obstruction (4.5%). There was no statistically significant difference (p > .05) in the occurrence of various prenatal ultrasound findings by etiology. CONCLUSION: Multiple prenatal ultrasound markers have been identified for MP. To improve the efficacy of newborn treatment for FMP and reduce neonatal mortality, dynamic monitoring of ultrasound image alterations and strengthened integrated perinatal management are necessary.

A Clinical Analysis of the Diagnosis and Treatment of Fetal Sacrococcygeal Teratomas.

OBJECTIVE: The present study aims to discuss the clinical features, treatment, and prognosis of fetal sacrococcygeal teratomas (SCTs) to improve the standard of diagnosis and treatment. METHODS: The clinical data of 15 pregnant females with fetal SCT, admitted to Fujian  Maternity and Child Health Hospital from January 2013 to January 2020, were retrospectively analyzed with respect to clinical characteristics, imaging features, complications, treatment options, and pregnancy outcomes. RESULTS: The 15 cases of fetal SCT were all detected by color ultrasonography. There were two cases of cystic tumors and 13 cases of solid cystic tumors. In terms of tumor blood supply, there was one case without blood flow signal, eight cases with little blood flow signal, and six cases with abundant blood flow. At the time of delivery, there were two cases with a tumor diameter less than 5 cm, five cases with a diameter of 5-10 cm, and eight cases with a diameter of more than 10 cm. In terms of tumor shape and location, there were two cases of type I, ten cases of type II, and three cases of type III. There were six cases with an increased fetal heart to chest ratio, four cases of fetal edema, three cases of placental edema, four cases of excessive amniotic fluid, one case of insufficient amniotic fluid, three cases of fetal distress, one case of stillbirth, two cases of gestational diabetes mellitus, two cases of mirror syndrome, and two cases of postpartum hemorrhage. According to the pathological diagnosis, there were seven cases of mature teratoma, seven cases of immature teratoma, and one case of mixed germ cell tumor. There were six cases of induced delivery, nine cases of cesarean section, one case of premature birth, and two cases of mild neonatal asphyxia. CONCLUSION: Fetal SCT was generally diagnosed by prenatal ultrasonography. The tumor blood supply, growth rate, size, nature of the tumor, clinical type, pathology, and maternal-fetal complications are all closely correlated with the prognosis. The timing and manner of the termination of pregnancy should be determined on the basis of the pregnant female, the fetus, and the tumor.

An analysis of the maternal and infant outcomes in the delayed interval delivery of twins.

OBJECTIVE: To investigate the treatment methods used for the delayed interval delivery of twins and to evaluate the maternal and infant outcomes. MATERIALS AND METHODS: The clinical data of 5 patients that underwent delayed interval delivery of twins at Fujian Maternal and Child Health Hospital from 2014 to 2018 were analyzed. The gestational ages at delivery, obstetrical management, the interval between deliveries, and the maternal and child outcomes were analyzed. RESULTS: The average gestational age at delivery of the first child was 23+3 weeks (range: 20+1-30+2 weeks). All 5 mothers underwent high ligation of the umbilical cord and received prophylactic antibiotic treatment. Tocolytics were administered to 3 patients, 1 of which had previously undergone cervical cerclage placement. No tocolytics were administered to the remaining 2 patients. The average delayed delivery time was 15 days (range: 3-31 days). The second child was delivered at an average gestational age of 25+5 weeks (range: 20+4-31+3 weeks). The average birth weight of the second twin was 957 g (range: 360-1930 g). Three of the patients delivered vaginally, 1 delivered via a cesarean section, and 1 required a breech extraction. Of these deliveries, there were 3 neonatal survivals. Pathogens were detected in the cervical secretion cultures in all cases. Two patients had grade 2 placental abruption, 5 had an intrauterine infection, 1 developed sepsis, 1 developed postpartum hemorrhage, and 5 showed a placenta adherence. CONCLUSION: The delayed interval delivery of twins is a unique treatment for patients experiencing a twin pregnancy. Successful performance of this method can improve the survival rates for the second twin and improve prognosis. However, careful attention is required when performing this treatment to prevent and treat possible complications that may arise during the procedure.