Evaluation of ultrasonography in fetal intestinal malrotation with midgut volvulus

Ginekol Pol. 2022;93(4):296-301. doi: 10.5603/GP.a2021.0237. Epub 2022 Feb 14.

Abstract

Objectives: To investigate the clinical significance of prenatal diagnosis and prognostic evaluation of fetal intestinal malrotation with midgut volvulus via ultrasonography.

Material and methods: Ultrasonographic findings and clinical outcomes of fetal intestinal malrotation with midgut volvulus prenatally diagnosed via ultrasound at the Zhangzhou Hospital Affiliated of Fujian Medical University from January 2013 to May 2020 were summarised and analyzed.

Results: Eleven cases of fetal intestinal malrotation with midgut volvulus were accurately prenatally diagnosed according to the specific ultrasound signs, such as 'whirlpool sign' and 'twining sign'. Indirect and nonspecific ultrasonographic signs included ascites in four cases and echogenic bowel in nine, all of which were accompanied by intestinal dilatation at various degrees. Among all cases, two were complicated with other system abnormalities, and one had a chromosome abnormality. Three pregnant women chose termination of pregnancy, and eight neonates were transferred to the pediatric department for surgery after obtaining written informed consent. An accurate prenatal diagnosis was confirmed postoperatively, and the fetus recovered well postoperatively.

Conclusion: S: : Fetal intestinal malrotation with midgut volvulus has typical sonographic features, and ultrasonography is the method of choice for prenatal diagnosis of this disease. Fetal intestinal malrotation with midgut volvulus is a non-fatal congenital malformation that can be treated. Prenatal diagnosis is essential for early postnatal treatment, and early surgery can often obtain good efficacy and prognosis.

Keywords: intestinal malrotation; midgut volvulus; prenatal; ultrasonography; whirlpool sign.

MeSH terms

  • Child
  • Digestive System Abnormalities* / diagnostic imaging
  • Digestive System Abnormalities* / surgery
  • Female
  • Fetus
  • Humans
  • Infant, Newborn
  • Intestinal Volvulus* / diagnostic imaging
  • Intestinal Volvulus* / surgery
  • Pregnancy
  • Ultrasonography

Supplementary concepts

  • Volvulus Of Midgut