To investigate the sonographic features and prenatal clinical management of fetal small bowel volvulus.

The clinical data of 9 cases of fetal small bowel volvulus confirmed by prenatal ultrasound and/or postpartum neonatal surgery at Shandong Maternal and Child Health Hospital Affiliated to Qingdao University were retrospectively analyzed, including general characteristics of pregnant women, prenatal sonographic manifestations, and pregnancy outcome. The ultrasonographic characteristics and their prenatal clinical significance were summarized.

All fetuses showed small bowel dilatation and typical "whirlpool" sign on the two-dimensional sonogram at the first ultrasound diagnosis. Of the 9 fetuses, 2 underwent emergency cesarean section due to the disappearance of intestinal peristalsis, massive ascites, and fetal intrauterine hypoxia, and the remaining 7 were scheduled for ultrasound follow-up because of reassuring ultrasound findings. During the follow-up, spontaneous intrauterine regression of the volvulus occurred in 3 fetuses, 2 fetuses underwent emergency cesarean section, 1 fetuses underwent vaginal delivery because of premature rupture of membrane, and 1 case underwent induced labor. Five newborns were operated within 0-3 days after delivery and all of them recovered well.

Intestinal distention and "whirlpool" sign are the important ultrasonic features of fetal small bowel volvulus. The disappearance of intestinal peristalsis in the volvulus segment, massive fetal ascites, and intrauterine hypoxia are the main indications for emergency prenatal clinical intervention.