PF.66 Prognostic Significance an Enlarged Fetal Stomach in the Second Trimester

Richardson, John R.; Boxall, Sally; Stanwell, Joanna; Wellesley, Diana; Brackley, Karen

doi:10.1136/archdischild-2013-303966.074

Cited by 2 publications

(3 citation statements)

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“…The prognostic relevance of an enlarged fetal stomach in the second trimester was researched by Richardson et al (11) , who concluded that the detection of an isolated larger stomach in the second trimester appears to have a positive prognosis with no related feeding issues.…”

Section: Discussionmentioning

confidence: 99%

Standardization of Reference Values for Fetal Gastric Size in Normal Gesta

Mousa¹,

ElGendy²,

Ella³

2023

The Egyptian Journal of Hospital Medicine

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Background: On ultrasound, the stomach may be seen in the fetal abdomen's left upper quadrant as an echolucent organ. At around 14 weeks of gestation, the larger and lesser curvatures, the fundus, the body, and the pylorus can all be seen as part of the stomach's distinctive structure. Numerous malformations and a poor fetal outcome can be linked to a fetal stomach that is non-visualized, dilated, or even tiny. Objectives: The aim of the current study was to establish standardized reference values for fetal stomach size throughout normal pregnancy as demonstrated during routine antenatal ultrasonography. Patients and methods: This was a longitudinal multicentric study of 260 normal singleton Pregnancies, sonographic evaluation was carried out between the 14th and 40th weeks of gestation. The pregnant women entered the study during the period from January 2020 to October 2022 and were evaluated in the unit of ultrasonography of Menoufia University Hospitals. Results: Fetal gastric area was found more significant correlated with gastric circumference (r=0.991, P-value <0.001) and gastric volume (r=0.988, P-value <0.001), however fetal gastric area was found less significant correlated with gestational age (r=0.962, P-value <0.001) and gastric longitudinal diameter (r=0.968, P-value <0.001). Fetal gastric area was more significant correlated with abdominal volume (r=0.928, P-value <0.001) and abdominal area ( r=0.914, P-value <0.001), however fetal gastric area was less significant correlated with Abdominal longitudinal (r=0.863, P-value <0.001) and abdominal anterior posterior diameter (r=0.866, P-value <0.001). Conclusions: In a healthy pregnancy, fetal stomach dimensions are correlated with gestational age, and a nomogram of fetal gastric development may be helpful in determining if the fetus is developing normally and whether any digestive system abnormalities exist.

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Section: Discussionmentioning

confidence: 99%

Standardization of Reference Values for Fetal Gastric Size in Normal Gesta

Mousa¹,

ElGendy²,

Ella³

2023

The Egyptian Journal of Hospital Medicine

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“…Similar findings were reflected in a retrospective study analyzing 33 cases of enlarged fetal stomachs in the second trimester. 20 Of the 19 isolated large stomach cases, no GI anomalies were noted postnatally. 20 We saw similar results on a larger scale, determining that an isolated large stomach on US signifies a GI obstruction less than 1% of the time.…”

Section: Research Implicationsmentioning

confidence: 97%

“…20 Of the 19 isolated large stomach cases, no GI anomalies were noted postnatally. 20 We saw similar results on a larger scale, determining that an isolated large stomach on US signifies a GI obstruction less than 1% of the time. In addition, our study found 65.8% of isolated large stomachs resolve before birth, whereas the earlier study found that 48% resolved.…”

Section: Research Implicationsmentioning

confidence: 97%

Outcomes of both complex and isolated cases of infants with large stomach on fetal ultrasound

McCormick

Johnson

Bishop

et al. 2021

American Journal of Obstetrics & Gynecology MFM

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BACKGROUND: A sonographically large fetal stomach has been associated with gastrointestinal obstruction, per case reports, and is often followed up with serial ultrasound examinations. The frequency of this phenomenon has not been systematically studied, resulting in challenges in counseling parents about the prognosis and making cost-benefit analysis of serial ultrasound follow-up difficult to assess. OBJECTIVE: This study aimed to determine the frequency at which an enlarged fetal stomach as the sole abnormality on fetal ultrasound reflects a bowel obstruction to aid in parental counseling and determine the best practice for follow-up. STUDY DESIGN: We performed a retrospective cohort study of all prenatal sonographic cases in which a large fetal stomach was visualized between January 1, 2002, and June 1, 2016. The inclusion criteria required a fetal diagnosis of a large stomach, defined as an increased measurement in 2 dimensions based on a nomogram, that resulted in a liveborn delivery within the Johns Hopkins Health System. We excluded pregnancy loss, pregnancy termination, and cases delivered outside of the Johns Hopkins Health System. Cases were subclassified as isolated or complex based on the absence or presence of additional ultrasound findings at initial presentation of the enlarged stomach. The perinatal outcomes and maternal demographics were determined and compared between isolated and complex cases. RESULTS: Of 57,346 total cases with ultrasound examinations in the Johns Hopkins Health System within the study time frame, 348 fetuses had enlarged stomachs, with 241 (69.3%) who met the inclusion criteria as follows: 161 (66.8%) isolated and 80 (33.2%) complex. Of the 161 isolated cases, 1 resulted in neonatal small bowel obstruction (0.62%). Of note, 158 of the isolated large stomach cases (98.1%) had no postnatal abnormalities of any kind. Of the 80 complex cases, 18 (22.5%) resulted in neonatal gastrointestinal obstruction (14 cases of duodenal atresia and 4 cases of jejunal atresia). Those with isolated findings were significantly less likely to deliver preterm ( n¼24[14.9%] vs n¼35 [43.8%]; P<.001), be complicated by polyhydramnios (n¼18 [11.2%] vs n¼23 [28.8%]; P<.001), have a neonatal intensive care unit admission (n¼31 [19.3%] vs n¼76 [95.0%]; P<.01), or have a major surgical procedure (n¼2 [1.2%] vs n¼66 [82.5]; P<.001) compared with complex cases. CONCLUSION:We found that 0.62% of isolated large fetal stomachs (1 of 161) were associated with neonatal intestinal obstruction. Of the complex cases with an enlarged stomach, 18 of 80 (22.5%) were found to have a gastrointestinal obstruction; by definition, none of these complex cases began as an isolated large stomach as their initial ultrasound finding, but rather had other concurrent sonographic abnormalities, including a double bubble sign and intestinal dilation. With a prevalence of <1% resulting in the development of a small bowel obstruction, our results suggest that, when isolated, a large stomach does not seem to warrant serial prenatal ...

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PF.66 Prognostic Significance an Enlarged Fetal Stomach in the Second Trimester

Cited by 2 publications

References 0 publications

Standardization of Reference Values for Fetal Gastric Size in Normal Gesta

Standardization of Reference Values for Fetal Gastric Size in Normal Gesta

Outcomes of both complex and isolated cases of infants with large stomach on fetal ultrasound

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