Title

Fetal Meconium Peritonitis Associated with Prenatal Methamphetamine Exposure

DOI

10.29787/TJOG.200506.0016

Authors

Wen-Jui Yang;Chie-Pein Chen;Chen-Yu Chen;Kuo-Gon Wang;Tsung-Hsien Su

Key Words

meconium peritonitis ; methamphetamine

PublicationName

Taiwanese Journal of Obstetrics & Gynecology

Volume or Term/Year and Month of Publication

44卷2期(2005 / 06 / 01)

Page #

180 - 182

Content Language

英文

English Abstract

Objective: In roughly 50% of all patients with meconium peritonitis, there is no evidence of primary obstruction of the bowel. We report a case of maternal methamphetamine and heroin abuse complicated by fetal meconium pseudocyst without a definite intestinal obstructive lesion. We discuss the correlation between the presence of meconium peritonitis and prenatal exposure to methamphetamine. Case Report: A 19-year-old, gravida 2, para 0, abortus 1, woman had abused illegal drugs, including methamphetamine and intravenous heroin. Suffering from withdrawal symptoms, she was taken to a shelter where she was diagnosed with a pregnancy of 26 weeks' gestation. The patient underwent cesarean section at 34 weeks due to preterm labor and fetal malpresentation. A boy weighing 2,474 g was born, but had to be intubated and admitted to the intensive care unit because of a distended abdomen and respiratory distress. A laparotomy performed on the second day of life revealed a large calcified pseudocyst associated with two perforations of the distal jejunum. A segmental resection of the jejunum with primary anastomosis was performed. The infant recovered well after the operation and was discharged 65 days after birth. Conclusion: Since methamphetamine is a powerful α-adrenergic stimulant and induces the release of catecholamines from adrenergic synapses, it can cause powerful vessel constriction. Prenatal exposure to methamphetamine can cause disruption of mesenteric blood flow with transmural necrosis of the bowel, resulting in bowel perforation and meconium peritonitis.

Topic Category 醫藥衛生 > 預防保健與衛生學
醫藥衛生 > 婦產科與老幼科
醫藥衛生 > 社會醫學