Meconium peritonitis occurs -
Meconium Peritonitis 

Meconium is a sterile mixture of epithelial cells, mucin, salts, fats and bile and is formed when the fetus commences to swallow amniotic fluid.
Meconium peritonitis is due to intestinal perforation mostly the result of some form of neonatal intestinal obstruction (eg. meconium ileus in cystic fibrosis patients).
When meconium enters the peritoneal cavity, an exudate is secreted that organizes rapidly, matting of intestinal loops occur, and in many cases in a matter of weeks, the extruded becomes calcified.
Meconium remains sterile until about 3 hrs after birth; thereafter, unless the perforation has become sealed, sterile meconium peritonitis gives place to acute bacterial peritonitis which unless treated promptly is rapidly fatal.
The clinical picture may be that of peritonitis and/or intestinal obstruction.


Meconium peritonitis should always be suspected when a baby is born with a tense abdomen, who is vomiting and in whom there is a failure to discharge meconium.

Treatment

Prognosis is poor but recovery may follow prompt operation.
Treatment consists of elimination of intestinal obstruction, closure of perforation and drainage of the peritoneal cavity.
Just before birth
Just after birth
Before and after birth
Due to birth trauma