Department of Pediatric Surgery, Başkent University, Faculty of Medicine, Ankara, Turkey.
Department of Obstetrics and Gynaecology, Başkent University, Faculty of Medicine, Ankara, Turkey.
J Perinatol. 2024 Nov;44(11):1543-1551. doi: 10.1038/s41372-024-01984-6. Epub 2024 May 4.
Our objective is to analyse the observations related to intrauterine volvulus and assess how clinical manifestations and treatment strategies impact prognosis. We conducted a comprehensive search on Pubmed and ClinicalTrials.gov from inception to July 2022, using search terms like "intrauterine volvulus" or "foetal volvulus," supplemented by manual scrutiny of reference lists in relevant texts and articles. Our review encompassed 57 case reports/case series, involving 88 cases. The presence of foetal bradycardia during prenatal visits (p = 0.002) and the existence of meconium cyst or pseudocyst (p = 0.038) significantly influence survival rates. Preterm labour occurred more frequently among cases resulting in mortality (54% vs 21%; p = 0.055). Our study's limitations include the inability to access all reported cases and reliance solely on available data. We advocate for vigilant monitoring of foetuses exhibiting signs of intestinal obstruction, and consideration of an emergent caesarean section as a pre-emptive measure before foetal biophysical profile deterioration worsens.
我们的目的是分析与子宫内扭转相关的观察结果，并评估临床表现和治疗策略如何影响预后。我们在 PubMed 和 ClinicalTrials.gov 上进行了全面的检索，检索时间从建库到 2022 年 7 月，使用的检索词包括“子宫内扭转”或“胎儿扭转”，并辅以对相关文本和文章的参考文献列表的手动审查。我们的综述包括 57 篇病例报告/病例系列，涉及 88 例病例。产前检查中出现胎儿心动过缓（p=0.002）和存在胎粪囊肿或假囊肿（p=0.038）显著影响生存率。导致死亡的病例中早产更为常见（54%比 21%；p=0.055）。我们研究的局限性包括无法获取所有报告的病例和仅依赖现有数据。我们主张对表现出肠梗阻迹象的胎儿进行密切监测，并考虑在胎儿生物物理特征恶化之前，紧急行剖宫产术作为预防措施。
