PDF(Pubmed)
Abstract：
Fetal intestinal volvulus is a rare condition that can lead to hemorrhage, bowel necrosis, and urgent surgical treatment after birth. Thus, prompt diagnosis and treatment are essential to avoiding fetal or neonatal demise. Prenatal ultrasound is a keystone tool in the diagnostic course. However, sonographic findings tend to be non-specific, with limited understanding of the pathophysiology behind their atypical presentation. With a literature review and a case series, we aim to optimize the antenatal diagnosis and management of this rare but life-threatening condition. Six cases from our institution were retrospectively analyzed over 12 years. A literature review was conducted until December 2022. A total of 300 articles matched the keyword \"Fetal volvulus\", and 52 studies were eligible for the review. Our 6 cases are added to the 107 cases reported in the literature of fetal intestinal volvulus with antenatal ultrasound assessment and without associated gastroschisis or omphalocele. Several prenatal symptoms and ultrasound markers, even if not specific, were more frequently reported. Different experiences of management were described regarding follow-up, the timing of delivery, the mode of delivery, and surgery outcomes. This paper highlights the importance of suspecting and assessing fetal volvulus at routine ultrasound scans, describing the most frequent antenatal presentations and management in order to improve fetal and neonatal outcomes.
摘要：
胎儿肠扭转是一种罕见的疾病，可导致出血，肠坏死,出生后紧急手术治疗。因此，及时诊断和治疗对于避免胎儿或新生儿死亡至关重要。产前超声是诊断过程中的重要工具。然而,超声检查结果往往是非特异性的，对其非典型表现背后的病理生理学理解有限。通过文献综述和案例系列，我们的目标是优化这种罕见但危及生命的疾病的产前诊断和管理。对我院12年来的6例病例进行回顾性分析。文献综述一直进行到2022年12月。共有300篇文章匹配关键字\"胎儿扭转\",52项研究符合审查条件.我们的6例病例被添加到文献报道的107例胎儿肠扭转中，并进行了产前超声评估，并且没有相关的胃裂或脐膨出。几个产前症状和超声标记，即使不具体，更经常被报道。描述了关于后续行动的不同管理经验，交货时间，交付方式，和手术结果。本文强调了在常规超声扫描中怀疑和评估胎儿扭转的重要性，描述最频繁的产前介绍和管理，以改善胎儿和新生儿结局。
