Fetal Midgut Volvulus with a Cystic Appearance, Accompanying a Sinus Rhythm and an Increased Peak Systolic Velocity without Anemia.

A midgut volvulus rarely occurs in a fetus; however, when it does, it requires an immediate diagnosis and surgery. Thirty-week pregnant was referred to our clinic with a diagnosis of a fetal abdominal cystic mass and preterm labor. The initial ultrasound examination revealed a female fetus with a 55 × 50 mm cystic mass in the lower abdomen, which was preliminarily diagnosed as an ovarian cyst. There was a sinusoidal rhythm on cardiography. The middle cerebral artery peak systolic velocity was 60.4 cm/sec, compatible with 1.49 MoMs that suggested fetal anemia on Doppler examination. Uterine contractions were observed with tocography and maternal hydration was administered for tocolytic treatment. Despite hydration, uterine contractions continued and the infant was delivered. A newborn ultrasonographic evaluation revealed a 6 cm abdominal cyst, and plain abdominal radiographs revealed distended loops of the small bowel on the left side. Emergency surgery was performed. A midgut volvulus leading to dilatation and necrosis of the small bowel without anatomical causes was observed during laparotomy. The necrotic bowel loop was resected and an end-to-end anastomosis was performed. The newborn died due to multiorgan failure. Obstetricians should be familiar with the appropriate diagnosis and management of a fetal volvulus.

Comparison of serum granulocyte colony-stimulating factor levels between preterm and term births.

OBJECTIVE: Preterm birth (PTB) is the major obstetric problem in developed countries, accounting for the majority of neonatal mortality and morbidity. Granulocyte colony-stimulating factor (G-CSF) is a hematopoietic cytokine that mediates the increase in leukocytes in pregnancy and may play a role in placentation. We aimed to investigate the differences of serum G-CSF levels between subsequent spontaneous PTB and term-delivered healthy pregnant women. MATERIAL AND METHODS: Serum samples, collected from total of 600 singleton otherwise healthy pregnants at 24-28 weeks of gestation during a routine antenatal visit, were used to assess G-CSF levels; 40 of the total pregnants who delivered their infants spontaneously after preterm labor before 37 weeks of gestation were selected as the study group. Also, 120 pregnants were selected as a control group using a 1/3 ratio. Student's t-test, chi-square test, Mann-Whitney U-tests, and ROC curve analysis for prediction of PTB were used for the comparison of groups. P<0.05 was accepted as statistically significant. RESULTS: There was no significant difference in maternal serum G-CSF levels between the study and control groups (p=0.28) but maternal white blood cell (WBC) count was significantly different between them (p=0.00). In addition, G-CSF was insufficient in the prediction of PTB (AUC=0.419). In the preterm and term groups, no correlation was found between WBC and G-CSF (p=0.165 vs. p=0.703). CONCLUSION: There were no differences in serum levels of G-CSF between term- and preterm-delivered pregnants. There was no predictive role for serum G-CSF in PTB.