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Midgut volvulus causing fetal demise in utero
Thora S Steffensen1, Enid Gilbert-Barness, Kimberly A DeStefano
1Department of Pathology, University of South Florida, Tampa General Hospital, Tampa, Florida 33606, USA.
Fetal and Pediatric Pathology
|September 19, 2008
Summary
Midgut volvulus, a rare intestinal malrotation complication, can cause fetal demise. This case highlights intrauterine fetal death at 38 weeks due to midgut volvulus and associated anomalies.
Area of Science:
- Medical Science
- Pediatric Surgery
- Fetal Medicine
Background:
- Intestinal malrotation affects 1 in 6000 live births, with midgut volvulus being its most severe complication.
- Midgut volvulus involves the twisting of the small bowel and proximal colon around the superior mesenteric artery, potentially causing bowel infarction.
- While rare, midgut volvulus can lead to intrauterine fetal demise, with only seven prior reported cases.
Observation:
- This report details a case of intrauterine fetal demise at 38 weeks gestation.
- Antenatal ultrasound identified non-specific abnormalities such as ascites and dilated bowel starting from 15 weeks gestation.
- The fetus presented with midgut volvulus, intestinal atresia, and arthrogryposis.
Findings:
- The intrauterine fetal demise was attributed to cardiovascular failure and shock secondary to midgut volvulus.
- This case represents a rare instance of fetal death caused by midgut volvulus.
Implications:
- This case underscores the critical importance of recognizing subtle antenatal ultrasound findings suggestive of midgut volvulus.
- Early detection and intervention strategies for fetal midgut volvulus may be crucial in preventing devastating outcomes.
- Further research into the prenatal diagnosis and management of midgut volvulus is warranted to improve fetal outcomes.
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