| Congenital midgut volvulus associated with fetal anemia. | |
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MedLine Citation:
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PMID: 20616522 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Congenital volvulus is a life-threatening condition, both for the fetus and for the newborn. A volvulus is a twist of small bowel loops or a proximal part of the colon around the mesenteric artery or its branches. The potential consequences of volvulus are ileus and necrosis of the intestinal wall. Prenatal diagnosis of midgut volvulus is difficult. It should be suspected antenatally when polyhydramnios, intestinal dilatation, ascites and/or signs of fetal anemia are present on ultrasound assessment. We report a case of a congenital midgut volvulus associated with fetal anemia. The fetal ultrasound performed at 32 weeks' gestation showed a polyhydramnios, hydrothorax, thick ascites accumulation around the liver and the suspicion of a dilated bowel loop. Additionally, Doppler examination showed an increased value of peak systolic velocity in the middle cerebral artery. Cordocentesis confirmed significant fetal anemia. At 34 weeks, because of the suspicion of idiopathic meconium ileus and secondary anemia, a Cesarean section was performed after the administration of steroids. During the laparatomy, performed postnatally, a midgut volvulus was diagnosed. The affected portion of the ileum was resected and end-to-end anastomosis performed. An antenatal diagnosis of midgut volvulus should be considered when signs of fetal anemia, including an increased value of peak systolic velocity in the middle cerebral artery, are present with polyhydramnios, fetal ascites, dilated bowel loops on antenatal ultrasound. An assessment of the fetal hemodynamic status should be a part of the ultrasound assessment for patients with nonspecific fetal bowel pathologies, including congenital volvulus. |
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Authors:
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Jakub Kornacki; Monika Czarnecka; Michał Błaszczyński; Jana Skrzypczak; Janusz Gadzinowski; Andrzej Jankowski; Smeeta Sardesai |
Publication Detail:
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Type: Case Reports; Journal Article Date: 2010-07-09 |
Journal Detail:
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Title: Fetal diagnosis and therapy Volume: 28 ISSN: 1421-9964 ISO Abbreviation: Fetal. Diagn. Ther. Publication Date: 2010 |
Date Detail:
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Created Date: 2010-08-27 Completed Date: 2010-12-21 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9107463 Medline TA: Fetal Diagn Ther Country: Switzerland |
Other Details:
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Languages: eng Pagination: 119-22 Citation Subset: IM |
Copyright Information:
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Copyright (c) 2010 S. Karger AG, Basel. |
Affiliation:
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Division of Reproduction, Department of Gynecology, Obstetrics and Oncology, Poznań University of Medical Sciences, Poznań, Poland. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Amniotic Fluid Anemia / complications, diagnosis Ascites / complications, ultrasonography Female Fetal Diseases / diagnosis, surgery, ultrasonography Humans Hydrothorax / complications, ultrasonography Infant, Newborn Intestinal Volvulus / complications, diagnosis*, surgery Polyhydramnios / ultrasonography Pregnancy Ultrasonography, Prenatal* |
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