Duodenal atresia and sudden fetal death. Running head: Prenatal diagnosis of fetal duodenal atresia and risk of fetal adverse outcome

Duodenal atresia occurs in approximately 1:10.000 live births. The outcome of congenital duodenal obstructions, in terms of mortality rate, has improved over the last decades, mainly attributable to the improvement in the quality of prenatal diagnosis and neonatal intensive care. Nevertheless, several cases of sudden intrauterine fetal death (IUFD) in fetuses with duodenal obstruction have been described in the Literature. We report a case of a fetus with duodenal atresia and sudden IUFD at 32 weeks’ gestation and the review of literature. We speculate that the fetal demise was due to a vaso-vagal reaction initiated by esophageal dysmotility. This report is intended to describe the features of duodenal obstruction on prenatal ultrasonography and alert the obsterician to the possible association with sudden IUFD.