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Abdominal X-ray was performed and revealed gas filling the upper up to the lower
portion of the bowels.
CT scan was pserformed to reveal signs of calcification of the cerebrum which is related
to cytomegalovirus infection. There were no intracranial calcification, a hypodense mass
was found in the occipital,sulcus and gyrus seems normal.
Evaluation by neurosurgeon colleagues found intracranial haemorrhage of the occipital
and was treated conservatively. The latest condition of the fetus as per this report was in
good condition.
Disccussion
Experimental researches on animals points that calcification can be detected after
8 days after meconial leackage into the peritoneal cavity. The most frequent etiological
causes of MP include : ischaemical lession of the ileum which is related to mechanical
obstruction.( atresia, volvulus,inttusuception,congenital bands,diverticulum of Meckel
and internal hernia)
Those above affects up to 50% of MP cases.
MP can also be caused by viral infection (cytomegalovirus,parvovirus B19). Meconeal
ileus is also a known causative factor affecting less than 25% of MP cases.
Prenatal sonography to support the diagnosis of MP must reveal : intaabdominal
calcification, ascites, polyhydramnion and bowel dilatation.
Foster et al reported the incidence of sonographical findings of 7 cases of MP :
intraabdominal calcification 86%,ascites 64%,polyhydramnions 71%,signs of bowel
obstruction 46%.
There are three main types of MP which can be identified by prenatal ultrasound :
cystic ( pseudocyst meconeum), diffiuse and fibroadhessive.
Pseudocyst meconeum is the most frequent finding of MP cases which has an image of
hyperechoic mass. Ascites is also frequently found. Diffuse MP is usually associated with
polyhydramnion, fetal ascites and intraabdominal calcification. The fetal abdominal wall
seems thick because of edema. Fibroadhessive MP is due to calcium deposits within the
peritoneum which may close the lession of the bowel.