OP13.09: Association of isolated single umbilical artery with adverse perinatal outcome in 18,224 unselected patients

Abstract

other variants of intestinal obstruction. The use of the ‘‘whirlpool sign’’ and its three dimensional counterpart the ‘‘Barber-pole sign’’ have been used successfully in infants with high sensitivity and predictive value, establishing a definitive diagnosis of the condition. We present a case of a 52 year old primigravida who was evaluated due to complaints of decreased fetal movements. The fetal gray-scale sonogram showed a dilated bowel loop with the whirlpool sign, and the 3D Doppler study demonstrated a clockwise barber-pole sign, both of which were consistent with intestinal volvulus. The mother received betametasone for induction of lung maturity. Due to a non-reassuring pattern on fetal monitoring a cesarean section was performed. Laparotomy was performed shortly after birth, and a 360 degree distal ileum volvulus was observed. The necrotic intestine was resected and an ileostomy was made. Repeat laparotomy with resection of the ileocecal valve was subsequently required. The infant suffered from a short bowel syndrome, but is now doing well. This case further substantiates the importance of the clockwise whirlpool and barber-pole sign in the definitive diagnosis of prenatal volvulus. To the best of our knowledge, this is the first report of in utero volvulus diagnosed by 3D Doppler study.