Fetal Gastroschisis: A Comparison of Second vs. Third-Trimester Bowel Dilatation for Predicting Bowel Atresia and Neonatal Outcomes

Látó, Krisztián; Poellmann, Michael J.; Knippel, Alexander Johannes; Bizjak, G; Stressig, R; Hammer, Rüdiger; Janni, W; Kozlowski, P.

doi:10.1055/s-0031-1281753

Cited by 16 publications

(7 citation statements)

References 7 publications

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“…The predictive value for adverse perinatal outcome of different thresholds of bowel dilatation at the last prenatal ultrasound has been previously studied [16,26,27,28,29,30,31,32,33,34,35]. Controversially, Page et al [36] in a recent systematic review concluded that IABD seen on an antenatal ultrasound scan is not a finding associated with an increased risk of adverse perinatal outcome.…”

Section: Discussionmentioning

confidence: 99%

Predicting Perinatal Outcome from Prenatal Ultrasound Characteristics in Pregnancies Complicated by Gastroschisis

Martillotti

Boucoiran²,

Damphousse³

et al. 2015

Fetal Diagn Ther

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Introduction: The objective of the study was to establish the predictive value of prenatal ultrasound markers for complex gastroschisis (GS) in the first 10 days of life. Material and Methods: In this retrospective cohort study over 11 years (2000-2011) of 117 GS cases, the following prenatal ultrasound signs were analyzed at the last second- and third-trimester ultrasounds: intrauterine growth restriction, intra-abdominal bowel dilatation (IABD) adjusted for gestational age, extra-abdominal bowel dilatation (EABD) ≥25 mm, stomach dilatation, stomach herniation, perturbed mesenteric circulation, absence of bowel lumen and echogenic dilated bowel loops (EDBL). Results: Among 114 live births, 16 newborns had complex GS (14.0%). Death was seen in 16 cases (13.7%): 3 intrauterine fetal deaths, 9 complex GS and 4 simple GS. Second-trimester markers had limited predictive value. Third-trimester IABD, EABD, EDBL, absence of intestinal lumen and perturbed mesenteric circulation were statistically associated with complex GS and death. IABD was able to predict complex GS with a sensitivity of 50%, a specificity of 91%, a positive predictive value of 47% and a negative predictive value of 92%. Discussion: Third-trimester IABD adjusted for gestational age appears to be the prenatal ultrasound marker most strongly associated with adverse outcome in GS.

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Section: Discussionmentioning

confidence: 99%

Predicting Perinatal Outcome from Prenatal Ultrasound Characteristics in Pregnancies Complicated by Gastroschisis

Martillotti

Boucoiran²,

Damphousse³

et al. 2015

Fetal Diagn Ther

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“…Because congenital gastrointestinal abnormalities often require surgical correction during the neonatal period, there have been numerous efforts to identify prenatal sonographic findings that predict neonatal outcomes in patients with gastrointestinal anomalies. [9][10][11][12][13][14] Severe bowel dilatation seemed to be associated with poor postnatal outcomes in patients with gastroschisis, 15,16 whereas a dilated bowel and polyhydramnios showed no association with neonatal outcomes in jejunal and ileal atresia. 10,17 Regarding congenital duodenal obstruction, no reported study has focused on prenatal sonographic findings, including bowel dilatation, which could aid in the prediction of adverse outcomes.…”

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confidence: 98%

Association Between Prenatal Sonographic Findings of Duodenal Obstruction and Adverse Outcomes

Kim

You

Chang

et al. 2016

J of Ultrasound Medicine

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“…Intestinal malformations of the fetus lead to obstruction of amniotic fluid swallowing, so such fetuses are prone to polyhydramnios [17,18] . It also suggests that according to the position of fetal intestinal dilation, the occurrence of adverse pregnancy outcomes in pregnant women can be targeted, which is collaborated by previous studies that fetuses with bowel dilatation detected prenatally possess a greater odd of poor prognosis than normal fetuses [19][20][21] .…”

Section: Resultsmentioning

confidence: 80%

Correlation between Prenatal Ultrasound Diagnosis of Dilated Fetal Bowel and Fetal Prognosis

Su,

Li,

Sun

et al. 2023

IJPS

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To investigate the correlation between dilated fetal bowel detected by prenatal ultrasonography and fetal prognosis. In this retrospective study, a total of 157 pregnant women who underwent Doppler ultrasound obstetric examination in our hospital from August 2020 to August 2021 were included. All pregnant women were divided into the normal group and the dilation group according to the results of ultrasound diagnosis. The normal group was the pregnant women with normal fetal bowel diameter diagnosed by prenatal ultrasound. The dilation group was the pregnant women diagnosed with fetal bowel dilatation by prenatal ultrasound. Pregnant women in the dilation group were followed up until 1 mo after the delivery of the fetus. The dilation sites of all fetuses in the dilation group, pregnancy outcomes and neonatal Apgar scores were collected, and the correlation between fetal bowel dilatation and neonatal Apgar scores was analyzed. There was no significant difference in the above indices (p>0.05). The average inner diameter of the fetuses with duodenal canal dilatation, jejunal and ileal canal dilatation, and colonic canal dilation were negatively correlated with the neonatal Apgar score (r=-0.751, r=-0.723, r=-0.682, p<0.05). The incidence of premature birth, induced labor and polyhydramnios in fetuses with duodenal canal dilatation was significantly higher than that in fetuses with jejunal and colonic canal dilatation (p<0.05). Prenatal ultrasound diagnosis of dilated fetal bowel is correlated with fetal prognosis and has a predictive potential. Fetal duodenal dilatation or other abnormalities have a worse prognosis than small bowel or colonic dilatation alone, which is conducive to identify fetal status and implementation of preventive strategies.

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Fetal Gastroschisis: A Comparison of Second vs. Third-Trimester Bowel Dilatation for Predicting Bowel Atresia and Neonatal Outcomes

Cited by 16 publications

References 7 publications

Predicting Perinatal Outcome from Prenatal Ultrasound Characteristics in Pregnancies Complicated by Gastroschisis

Predicting Perinatal Outcome from Prenatal Ultrasound Characteristics in Pregnancies Complicated by Gastroschisis

Association Between Prenatal Sonographic Findings of Duodenal Obstruction and Adverse Outcomes

Correlation between Prenatal Ultrasound Diagnosis of Dilated Fetal Bowel and Fetal Prognosis

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