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On ultrasound assessment, a non-specific 17 11 mm mass was seen in the uterine fundus. The patient’s bleeding pattern improved after one cycle of combined oral contraceptives, but recurred 11 months later. Repeat ultrasound showed an enlarged homogeneous mass in the uterine wall measuring 36 33 mm (Figure 1). The patient was hemodynamically stable with mild leukocytosis (10.9 109/L with 90.6% neutrophils).

Meconium peritonitis usually results from perforation of the intestine occurring in utero or shortly after birth. The common features of meconium peritonitis on prenatal ultrasonography are a solitary calcified mass or disseminated intraperitoneal calcifications, ascites, pseudocyst, and occasionally polyhydramnios and fetal hydrops. We report a case where prenatal ultrasound revealed a calcified mass in the right upper quadrant of the abdomen. Subsequent magnetic resonance imaging (MRI) suggested simple meconium peritonitis. Fetal MRI is considered to be reliable for demonstrating meconium peritonitis. Prenatal diagnosis of meconium peritonitis and identification of associated malformations facilitate planning of delivery, earlier surgical counseling, and better neonatal outcome.