Prenatal Ultrasound Screening of Intestinal Malrotation With a Higher Risk of Volvulus

Study Overview
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Brief Summary
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The aim of this study was to assess the value of an unusual relative position of the superior mesenteric artery (SMA) and vein (SMV) to screen intestinal malrotation with a higher risk of volvulus. First, feasibility study was done to prove the reproducibility of ultrasound in diagnosis of anormal mesenteric vessels position. A systematic screening of the mesenteric vessels position was performed at each pregnancy required ultrasound. When the fœtus had an unusual position of the mesenteric vessels, an MRI was suggested between 30 and 35 GA and the couple met the pediatric surgery team. Few days after birth, an abdominal ultrasound was achieved as well as a barium enema and upper gastrointestinal. If there were a hight probability of malrotation with a higher risk of volvulus, a prophylactic surgery was proposed. The children were flollowed up during 1 year.

Official Title
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Prenatal Ultrasound Screening of Intestinal Malrotation With a Higher Risk of Volvulus: Value of The Relative Position of The Superior Mesenteric Artery and Vein. Future of the Children With an Antenatal Malrotation Suspicion

Conditions
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Intestinal Malrotation

Intervention / Treatment
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* Other: MRI between 30-35 GA
* Other: Pediatric surgeon meeting
* Other: Postnatal abdominal ultrasound, barium enema and upper gastrointestinal
* Other: +/- prophylactic surgery


Participation Criteria
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Eligibility Criteria
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Inclusion criteria: pregnant women second or third trimester ultrasound. Exclusion criteria: fœtal ultrasound anomaly

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: MRI between 30-35 GA|MRI between 30-35 GA|
|Other: Pediatric surgeon meeting|Pediatric surgeon meeting|
|Other: Postnatal abdominal ultrasound, barium enema and upper gastrointestinal|Postnatal abdominal ultrasound, barium enema and upper gastrointestinal|
|Other: +/- prophylactic surgery|+/- prophylactic surgery|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Reproducibility of ultrasound in the diagnosis of the abnormal position of the mesenteric vessels | Feasibility study to prove the reproducibility of ultrasound in diagnosis of anormal mesenteric vessels position. | 1 day (Pre and post natal ultrasound) | 
| Antenatal screening of intestinal malrotation | Antenatal screening of intestinal malrotation with higher risk of volvulus. | 1 day (Pre and post natal ultrasound) | 
| Future of the children with an ante natal diagnosis of intestinal malrotation | Future of the children with an ante natal diagnosis of intestinal malrotation | 1 year after birth | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Produce ante and postnatal strategy facing a situation of mesenteric vessels malposition. | Produce ante and postnatal strategy facing a situation of mesenteric vessels malposition. | 1 day (During Pregnancy) | 
| Produce ante and postnatal strategy facing a situation of mesenteric vessels malposition. | Produce ante and postnatal strategy facing a situation of mesenteric vessels malposition. | 1 day (after delivery) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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superior mesenteric artery, superior mesenteric vein, intestinal malrotation, volvulus, pregnant women, mesenteric vessels position, postnatal diagnosis, prophylactic surgery