Volume 21 Issue 5
May  2023
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Article Navigation >  Chinese Journal of General Practice  > 2023  >  21(5): 801-804
XIAO Xiuman, ZHU Libin, JIANG Na, PAN Yin, LIN Jinhan, WANG Rongyue, ZHU Jianghu, CHEN Shangqin. Clinical and ultrasonic characteristics and prognosis of neonatal intrauterine volvulus[J]. Chinese Journal of General Practice, 2023, 21(5): 801-804. doi: 10.16766/j.cnki.issn.1674-4152.002987
Citation: XIAO Xiuman, ZHU Libin, JIANG Na, PAN Yin, LIN Jinhan, WANG Rongyue, ZHU Jianghu, CHEN Shangqin. Clinical and ultrasonic characteristics and prognosis of neonatal intrauterine volvulus[J]. Chinese Journal of General Practice, 2023, 21(5): 801-804. doi: 10.16766/j.cnki.issn.1674-4152.002987
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Clinical and ultrasonic characteristics and prognosis of neonatal intrauterine volvulus

doi: 10.16766/j.cnki.issn.1674-4152.002987
  • 1.

    Department of Neonatology, Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325027, China

Funds:

 LGF21H040009

 Y2020075

  • Received Date: 2021-12-24
    Abstract
  •   Objective  To analyse the clinical characteristics and prognosis of children with intrauterine volvulus for reducing misdiagnosis and improving prognosis.  Methods  A retrospective review was conducted with intrauterine volvulus confirmed by postnatal operation in Second Affiliated Hospital & Yuying Children's Hospital of Wenzhou Medical University from June 2015 to April 2020.  Results  Ten children (4 males and 6 females) were included in the study. Six of them were born through caesarean section and 4 were via vaginal delivery. Among the children, 6 were preterm infants (4 cases born for caesarean section due to foetal distress) and 4 were full-term infants. Of the 10 foetuses, 7 had intestinal dilatation, 2 showed typical "vortex sign", 3 had ascites, 4 had abdominal cystic mass and 2 had polyhydramnios, which was discovered by antenatal 2D ultrasound. 5 cases had abnormal foetal heart rate before delivery. Among all the cases, 10 had abdominal distension, 4 vomited bile-like material, 8 had no foetal discharge, 2 had bloody stool immediately after birth and 7 had anaemia. Of the 10 cases, 7 had abdominal puncture, 6 had uncoagulable blood and 1 had faecal turbid liquid. All the 10 cases were operated within 48 hours, 5 cases with segmental volvulus and 5 cases with midgut volvulus. Eight cases were recovered and discharged from hospital. One neonate died because of massive necrosis of small intestine, and one baby died due to secondary infection. The survival rate was 80% (8/10).  Conclusion  Foetal intrauterine volvulus should be considered when prenatal ultrasound showed typical "vortex" sign and intestinal dilatation with ascites or progressive enlargement of abdominal cystic mass. If prenatal ultrasound showed intestinal dilatation and the patient had gastrointestinal symptoms such as abdominal distension, vomiting bile-like material or bloody stool immediately after birth, accompanied by anaemia, then intrauterine volvulus should be highly suspected. If peritoneal puncture fluid was bloody, then a definite diagnosis could be made. The key to improve the survival rate was multidisciplinary cooperation, the right time for delivery, early operation and active perioperative treatment.

     

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