Obstetrical and neonatological aspects of a child with atresia of the small bowel

Bergmans, M.G.M.; Merkus, J.M.W.M.; Baars, A. M.

doi:10.1515/jpme.1984.12.6.325

Cited by 8 publications

(25 citation statements)

References 16 publications

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“…In our experience, we have observed no mortality in the case of the fibroadhesive type. Though Bergmans et al [26] estimated 62% mortality in cases of bowel atresia, we found no neonatal death attributed solely to bowel atresia. Owing to early detection and immediate postnatal fasting, the rate of sepsis is low in comparison with reported series [16].…”

Section: Discussioncontrasting

confidence: 85%

Correlation of Prenatal Ultrasound and Postnatal Outcome in Meconium Peritonitis

et al. 2003

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Objectives: To study the relationship between prenatal ultrasound features and postnatal course of meconium peritonitis. Methods: Meconium peritonitis was diagnosed by prenatal ultrasound. Fetuses were treated by intrauterine paracentesis of ascites when indicated, and symptomatic newborns received surgery. Results: Totally 17 cases were enrolled. Prenatal ultrasound findings include abdominal calcification (16/17), fetal ascites (12/17), hydramnios (9/17), pseudocyst (7/17) and dilated bowel loop (6/17). Persistent ascites, pseudocyst or dilated bowel loop are most sensitive (92%) to predict postnatal surgery (p = 0.022). The survivors have a higher gestational age at birth (36.4 vs. 33.3 weeks, p = 0.008). Persistent ascites and postnatal persistent pulmonary hypertension of the newborns significantly correlate with neonatal mortality (p = 0.029 and 0.022). Conclusion: Prenatal ultrasound can predict the neonatal outcome in meconium peritonitis.

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Section: Discussioncontrasting

confidence: 85%

Correlation of Prenatal Ultrasound and Postnatal Outcome in Meconium Peritonitis

et al. 2003

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“…The prognosis for the fetus with meconium peritonitis depends on the underlying cause, although one is not usually identified, as in our patients. In cases with atresia of the bowel, a mortality of 62 per cent was reported (Bergsmans et al, 1984). Often the perforation closes spontaneously and no surgical intervention is required postnally; this was the case in all our patients.…”

Section: Discussionmentioning

confidence: 48%

Meconium peritonitis: Extrusion of meconium and different sonographical appearances in relation to the stage of the disease

1992

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By chance, we had the opportunity to make serial sonographic observations of the extrusion of meconium in a case of meconium peritonitis. Inflammation leads to exudative processes and production of fluid (ascites) in the fetal abdomen. Sonography at that stage of the disease may lead to a misdiagnosis such as 'fetal ascites' or 'non-immune hydrops'. After bowel perforation and extrusion of meconium, the latter appears as a solitary mass inside fetal ascites or as disseminated echogenic masses distributed subdiaphragmatically or perihepatically. Within a couple of days, in most cases the echogenicity of the masses increases. Calcifications lead to distinct shadowing. These calcifications are often the only visible signs of a previous meconium peritonitis. Serial sonograms are essential for the management of pregnancies with meconium peritonitis. If the amount of fetal ascites does not increase and no signs of cardiovascular stagnation appear, no invasive intrauterine diagnostic and therapeutic steps are required. In none out of the nine cases was a cause found.

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“…Gestation at diagnosis was reported in 80 (90.9%) cases 2–7,9,11–22,24–27,29,30,32–35,42–63,65 with a median gestation of 31.9 weeks (IQR 27–34)—in 32 of these cases 2,4,5,11,14,16,17,24–27,30,31,34,35,42,43,45–49,51,52,56–58 ultrasound findings precipitated iatrogenic delivery at a mean gestation of 34.2 weeks (SD 2.3). In 72 (81.8%) cases, 2–6,9,11,12,14–20,22,24–27,29–35,42,43,45–49,51–59,63–68 the mode of birth was reported. Of these, 48/72 (66.7%) infants 2,4–6,11,14–17,20,25,27,30,31,34,35,42,45–49,51–54,56–58,64–68 were delivered by caesarean section.…”

Section: Resultsmentioning

confidence: 99%

“…Early surgical intervention and delivery planning is crucial to reducing perinatal morbidity and mortality 3,13,14 . Prognostic determinants of outcome include length of viable bowel, birth weight, gestational age, presence of meconium peritonitis, oligohydramnios or other neonatal co‐morbidities 15–20 …”

Section: Introductionmentioning

confidence: 99%

Prenatal imaging features and perinatal outcomes of foetal volvulus–A literature review

et al. 2022

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Objective To conduct a review of the literature on foetal volvulus with emphasis on prenatal imaging, pregnancy characteristics and clinical outcomes. Methods A review of all published cases of foetal volvulus diagnosed prenatally and indexed in Medline, EBSCOhost, CINAHL, SOCIndex and Healthy Policy Reference Centre. Studies without antenatal sonographic signs of foetal volvulus and without a postpartum surgical diagnosis were excluded. Data were analysed for frequencies and distributions and tested for statistical significance. Results Eighty‐eight cases of foetal volvulus were identified from 58 published case reports/series. The most common ultrasound findings were dilated bowel/stomach (77.3%), polyhydramnios (30.7%) and whirlpool/snail sign (28.4%). Median gestation at diagnosis was 31.9 weeks (IQR 27–34) and mean gestation at delivery was 34.5 weeks (SD 2.8). Underlying aetiology included intestinal malrotation (15.9%), cystic fibrosis (14.8% of all cases, 32.5% of tested cases) and abnormal mesenteric fixation (12.5%). Complications included intestinal atresia (36.4%) and foetal anaemia (9.1%). The overall perinatal mortality rate was 14.5%. Conclusion Foetal volvulus is a rare condition with high rates of preterm birth and perinatal mortality. Intestinal malrotation and cystic fibrosis are common predisposing causes, although the majority are idiopathic. Bowel and/or gastric dilatation is by far the most common sonographic finding.

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Obstetrical and neonatological aspects of a child with atresia of the small bowel

Cited by 8 publications

References 16 publications

Correlation of Prenatal Ultrasound and Postnatal Outcome in Meconium Peritonitis

Correlation of Prenatal Ultrasound and Postnatal Outcome in Meconium Peritonitis

Meconium peritonitis: Extrusion of meconium and different sonographical appearances in relation to the stage of the disease

Prenatal imaging features and perinatal outcomes of foetal volvulus–A literature review

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