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Maternal Vernix Caseosa Peritonitis Following Premature Rupture of Fetal Membranes

Ira S. Schwartz, MD; Gaetano V. Bello, MD, PharmD; Gerald Feigin, MD; David H. Sherman, MD
JAMA. 1985;254(7):948-950. doi:10.1001/jama.1985.03360070086030.
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MATERNAL vernix caseosa peritonitis is an unusual complication of pregnancy. We report a case diagnosed in a woman who had premature rupture of the fetal membranes. Uterine-tubal reflux, whereby amniotic fluid gained access to the peritoneal cavity, is suggested as etiologic in this case.

Report of a Case 

Clinical Findings.—  A 31-year-old woman, para 01111, was admitted to the obstetrical service of the Mount Sinai Hospital, New York, three days after spontaneous rupture of the fetal membranes during the 25th week of an otherwise uneventful pregnancy. The patient was afebrile on admission with normal blood pressure and a nontender uterus without contractions, estimated to be 24 to 25 weeks by size. Real-time ultrasonography revealed a fetus of appropriate gestational age in breech presentation and a small amount of amniotic fluid. Sterile speculum examination revealed a closed cervix with leakage of nitrazine test-positive, clear fluid on Valsalva's maneuver. The fetal heart


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