Fetal duodenal obstructions: increased risk of prenatal sudden death

Brantberg, A.; Blaas, H‐G. K.; Salvesen, K. Å.; Haugen, S. E.; Møllerløkken, G.; Eik‐Nes, S. H.

doi:10.1046/j.1469-0705.2002.00831.x

Cited by 42 publications

(34 citation statements)

References 25 publications

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“…This finding supports the hypothesis that bile acid toxicity may have caused umbilical cord ulceration. Duodenal atresia is strongly associated with chromosomal abnormalities, mainly with the risk of trisomy 21 [1,2] . Eighteen cases of umbilical cord ulceration with duodenal and jejunoileal atresia were previously reported [3-9, 13, 14] and 12 of these 18 cases were confirmed by karyotyping.…”

Section: Discussionmentioning

confidence: 99%

“…The frequency of duodenal atresia is 1-10/100,000 live births [1,2] . The lesion may be diagnosed prenatally by identifying the 'double bubble' sonographic sign.…”

Section: Introductionmentioning

confidence: 99%

“…The lesion may be diagnosed prenatally by identifying the 'double bubble' sonographic sign. This prenatal diagnosis helps in planning delivery, resuscitation, and surgery; however, it may also indicate more severe morbidity [1] and mortality [2] . The malformation is associated with an about 50% chance of other congenital abnormalities, with a trisomy 21 present in approximately 30% of the cases [2] , and recent reports have suggested that duodenal atresia can be associated with umbilical cord ulceration [3][4][5][6][7][8][9] , which in turn may cause massive hemorrhage and may prove lethal to the fetus.…”

Section: Introductionmentioning

confidence: 99%

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Umbilical Cord Ulceration after Prenatal Diagnosis of Duodenal Atresia with Interstitial Deletion of Chromosome 13q: A Case Report

Yamamoto¹,

Yamada²,

Okazaki³

et al. 2008

Fetal Diagn Ther

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Umbilical cord ulceration complicated by massive local hemorrhage may be a lethal event in the fetus, and this ulceration has been reported to be associated with upper intestinal atresia. The diagnosis of umbilical cord bleeding is difficult. We present a case of umbilical cord ulceration, hemorrhage, and duodenal atresia which had, in addition, an interstitial deletion of chromosome 13q. A female infant weighing 1,691 g was delivered by cesarean section at 34 weeks of gestation and had resuscitation and laparotomy. Just before the cesarean section, ultrasonography showed a ‘double bubble’ sign and a linear shadow, suggesting fibrin in the amniotic cavity. This finding may help in the diagnosis of bleeding from the cord.

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Section: Discussionmentioning

confidence: 99%

“…The frequency of duodenal atresia is 1-10/100,000 live births [1,2] . The lesion may be diagnosed prenatally by identifying the 'double bubble' sonographic sign.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Umbilical Cord Ulceration after Prenatal Diagnosis of Duodenal Atresia with Interstitial Deletion of Chromosome 13q: A Case Report

Yamamoto¹,

Yamada²,

Okazaki³

et al. 2008

Fetal Diagn Ther

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“…A hyperdistended uterus predisposes preterm delivery [17][18][19] ; reduced intake of amniotic proteins by the foetus with a bowel obstruction may be responsible for poor intrauterine growth. A recent paper by Brantberg et al [20] highlights the possibility that foetuses with CDO could have an increased risk of sudden intrauterine death due to bradycardia-asystolia secondary to vagal overactivity, triggered by a distended upper gastrointestinal tract. Some cases of severe foetal haemorrhage associated with intestinal obstruction and hydramnios have also been reported [21] .…”

Section: Discussionmentioning

confidence: 99%

Prenatal Diagnosis of Duodenal Obstruction Selects Cases with a Higher Risk of Maternal-Foetal Complications and Demands in utero Transfer to a Tertiary Centre

et al. 2008

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Objectives: It was the aim of this study to determine if prenatal diagnosis of congenital duodenal obstruction (CDO) selects high-risk pregnancies and demands special perinatal attention. Methods: Medical records of 62 neonates with intrinsic CDO, admitted since 1981 in 2 institutions, were reviewed and divided into 2 groups: 39 cases, detected in utero by a prenatal ultrasonogram (group A), and 23 diagnosed at birth (group B). Prevalence of complete CDO, mean gestational age, mean birth weight, hydramnios, as well as maternal-foetal complications requiring emergency Caesarean section and associated with premature delivery were compared in the 2 groups. Results: A complete CDO was found in 77% of patients in group A versus 48% of patients in group B (p < 0.02). Differences in mean gestational age and mean birth weight in the 2 groups were non-significant. Prenatally diagnosed patients presented a higher prevalence of hydramnios, maternal-foetal complications and premature delivery. Conclusions: Prenatal diagnosis selects patients with complete CDO and hydramnios. These pregnancies present a high incidence of maternal-foetal complications, which may require an emergency Caesarean section, and are frequently associated with premature delivery. These aspects must be considered in prenatal counselling. In utero transfer to a tertiary centre for delivery and appropriate perinatal care should be recommended.

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“…A Norwegian study showed an increased risk of sudden, unexplained death in fetuses with small intestinal obstruction (14). Bradycardia episodes were recorded prior to fetal death and were interpreted as resulting from vagal overactivity associated with distension of the gastrointestinal tract.…”

Section: Discussionmentioning

confidence: 99%