Fetal primary volvulus with abnormal heart rate patterns on cardiotocography

H Kyozuka,H Tanaka,K Fujimori,M Chishiki,S Suzuki,T Murata

doi:10.12891/ceog4878.2019

Abstract

Fetal primary volvulus is a rare, life-threatening condition. The authors report a case of fetal primary volvulus which showed abnormal fetal heart rate (FHR) patterns on cardiotocography (CTG). A healthy, multiparous, 29-year-old woman was referred to the present facility due to fetal ascites. Ultrasound sonography (US) showed dilation of the fetal small bowel. CTG showed a non-reassuring FHR pattern and an emergency cesarian section was performed. A female newborn was delivered (1,515 grams, Apgar scores at one and five minutes: 5 and 7, respectively). Emergency laparotomy of the newborn showed necrotic volvulus without malrotation. The volvulus was resected, and a colostomy was performed. The infant was discharged three months after the operation without any complications.

Highlights

Fetal volvulus is a rare, life-threatening condition that requires emergency surgical treatment
The authors report a case of fetal primary volvulus which showed abnormal fetal heart rate (FHR) patterns on CTG
Our Ultrasound sonography (US) examination of the fetus showed that the small bowel was dilated to 19 mm, with a thickened and hyperechogenic intestinal wall, and a moderate amount of ascites (Figure 1)

Summary

Introduction

Fetal volvulus is a rare, life-threatening condition that requires emergency surgical treatment. The authors report a case of fetal primary volvulus which showed abnormal fetal heart rate (FHR) patterns on CTG. Our US examination of the fetus showed that the small bowel was dilated to 19 mm, with a thickened and hyperechogenic intestinal wall, and a moderate amount of ascites (Figure 1). The CTG showed decreased FHR variability and an absence of FHR acceleration for at least two hours (Figure 2). Based on the abnormal FHR pattern, non-reassuring fetal status was confirmed and an immediate caesarian section was performed.

Results

Conclusion