Vernix caseosa is the thick, whitish pasty material that collects on the skin of the term fetus.
Features of vernix caseosa peritonitis (VIP):
(1) The woman has a recent history of cesarean section. The onset may be delayed several weeks.
(2) The woman presents with signs and symptoms of peritonitis.
(3) There is evidence of a systemic inflammatory response with fever, tachycardia, hypotension and elevated C-reactive protein.
(4) The peritoneum shows aigns of extensive inflammation with a fibrinous exudate.
(5) Culture and Gram stain are negative for micro-organisms.
Histologic examination of peritoneal exudates shows inflammation and anucleate squamous cells. This can be more easily identified with an Immunoperoxidase stain for pankeratin.
Vigorous lavage of the peritoneal cavity (with drain placement) can remove the vernix caseosa.
