Prenatal Diagnosis of Antenatal Midgut Volvulus: Specific Ultrasound Features

Completed

• Conditions: Midgut Volvulus; Fetal Volvulus
• Interventions: Other: Fetal ultrasound during the second or third trimester/ Postnatal surgery / Post mortem examination

• Registration Number: NCT03362450
• Lead Sponsor: University Hospital, Montpellier

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.

Study Timeline

• Study Start: 2006-01-01
• Primary Completion: 2017-07-01
• Study Completion: 2017-09-30
• Status Verified: 2017-10
• Study First Submitted: 2017-10-25
• Study First Submitted QC: 2017-12-04
• Last Update Submitted: 2017-12-04
• Study First Posted: 2017-12-05
• Last Update Posted: 2017-12-05

Recruitment & Eligibility

• Status: COMPLETED
• Sex: Female
• Target Recruitment: 13

Inclusion Criteria

• postnatal diagnosis of prenatal volvulus based on post-natal findings and prenatal imaging findings

Exclusion Criteria

• the absence of prenatal imaging assessment

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Pregnant patients seen for second or third trimester	Fetal ultrasound during the second or third trimester/ Postnatal surgery / Post mortem examination	Foetus with diagnosis of prenatal volvulus based on post-natal findings and prenatal imaging findings

Primary Outcome Measures

Name	Time	Method
echography	the third (31-34 weeks) trimester after ultrasound screening	Observation of specific signs using echography for the diagnosis of fetal

Secondary Outcome Measures

Name	Time	Method
ultrasound signs of complication	just after delivery	Observation of ultrasound signs of complication of midgut volvulus during the pregnancy like meconial pseudocyst, ascites, meconial peritonitis.
presence or not of the volvulus	the third (31-34 weeks) after ultrasound screening	Observation of surgery outcome like presence or not of the volvulus
presence or not ileal atresia.	1 day	Observation of surgery outcome like presence or not ileal atresia after diagnostic ultrasound

Trial Locations

Locations (1)

Uhmontpellier; 🇫🇷 Montpellier, France