Fetal Volvulus, Midgut Volvulus
Conditions
Keywords
Midgut volvulus, Fetal volvulus, Whirlpool sign, Pregnant women, Position of mesenteric vessels, Post natal surgery, Foetopathology if performed, Hydro-meconium level in the dilated loops
Brief summary
Objective: The small bowel volvulus is a rare cause of intestinal obstruction which may occur in utero and whose prenatal diagnosis is difficult.Sonographic signs are mainly indirect and non specific.The aim of this study is to present a retrospective analysis of prenatal sonographicfindings in fetal segmental midgut volvulus.Thanks to this series the investigators could highlight the more specifics signs of the volvulus included a new pattern.
Detailed description
Objective: The small bowel volvulus is a rare cause of intestinal obstruction which may occur in utero and whose prenatal diagnosis is difficult. Sonographic signs are mainly indirect and nonspecific. The aim of this study is to present a retrospective analysis of prenatal sonographic findings in fetal segmental midgut volvulus. Thanks to this series the investigators could highlight the more specifics signs of the volvulus included a new pattern. Methods: Unicentric retrospective analysis of cases of prenatal midgut volvulus between 2006 and 2017. The primary inclusion criteria was postnatal diagnosis of prenatal volvulus based on post-natal findings and prenatal imaging findings. The exclusion criteria was the absence of prenatal imaging assessment. The investigators collected the clinical history and the echographic mode B and color Doppler. They have searched for some specific sign like whirlpool sign representing the winding of the mesenteric vein around the superior mesenteric arterywith color Doppler with arciform pattern of the midgut, hydro-meconium level in the dilated loops and position of mesenteric vessels for evaluation of the intestinal (mal) rotation. Gold standard was surgery or foetopathology if performed.
Interventions
OTHERFetal ultrasound during the second or third trimester/ Postnatal surgery / Post mortem examination
Fetal ultrasound during the second or third trimester Postnatal surgery Post mortem examination
Sponsors
University Hospital, Montpellier
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* postnatal diagnosis of prenatal volvulus based on post-natal findings and prenatal imaging findings
Exclusion criteria
* the absence of prenatal imaging assessment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| echography | during the second (22-24 weeks) after ultrasound screening | Observation of specific signs using echography for the diagnosis of fetal during the second (22-24 weeks) and the third (31-34 weeks) trimester after ultrasound screening and when diagnostic ultrasound were performedmidgut volvulus |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| ultrasound signs of complication | the third (31-34 weeks) after ultrasound screening | Observation of ultrasound signs of complication of midgut volvulus during the pregnancy like meconial pseudocyst, ascites, meconial peritonitis. |
| presence or not of the volvulus | 1 day | Observation of surgery outcome like presence or not of the volvulus after diagnostic ultrasound |
| presence or not ileal atresia. | during the second (22-24 weeks) after ultrasound screening | Observation of surgery outcome like presence or not ileal atresia |
Countries
France
Outcome results
None listed