Second‐trimester intra‐abdominal bowel dilation in fetuses with gastroschisis predicts neonatal bowel atresia

Abstract

Objective To determine in fetuses with gastroschisis the association between intra-abdominal bowel dilation in the second trimester and neonatal bowel atresia. Methods

Prenatal Risk Factors and Outcomes in Gastroschisis: A Meta-Analysis

“…Three studies 24,34,41 explored the association between IABD and the overall postnatal LOS. These studies used different thresholds of dilatation to define the bowel as abnormal; in the largest study, 24 fetuses with an IABD .14 mm had a significant prolonged LOS compared with those with less dilated bowel (80.…”

“…Looking at selected papers (Table 5 and 6) and assuming that IABD was a prenatal sign of complex gastroschisis, we showed that in the 3 largest series, there was a significant association between IABD/EABD and longer LOS. 24,33,41 In a recent systematic review, our group explored the role of prenatal ultrasound in detecting non-duodenal small bowel atresia in otherwise normal fetuses. 47 We found that ultrasound had a poor accuracy in detecting small bowel atresia either using bowel dilatation or polyhydramnios.…”

Gastroschisis and the Risk of Short Bowel Syndrome: Outcomes and Counselling

“…Therefore, there may be potential for interruption by timely delivery and salvage of longer portions of bowel. Some reports suggest that secondary trimester dilatation is strongly indicative of atresia [7] whilst others that persisting or progressing intra-abdominal dilatation and hyperperistalsis indicate a closing gastroschisis which should precipitate early delivery at or beyond 32 weeks' gestation [6]. Had these criteria been applied to case 4, delivery would have been at 34 weeks and more bowel may have been viable.…”

“…The correlation of these sonographic features with postnatal outcomes is under debate [5,6,7,8]. We present 4 cases to illustrate that counselling of parents with an antenatal scan of gastroschisis should include the possibilities of the vanishing lesion, as well as SBS.…”

Re: Second‐trimester intra‐abdominal bowel dilation in fetuses with gastroschisis predicts neonatal bowel atresia

“…It was with great interest that we read the article by Nick et al 1 in a recent issue of the Journal. Similar results were published in our article, 'Surveillance and outcome of fetuses with gastroschisis' 2 , and we strongly support the repeat findings by Nick et al, that intra-abdominal bowel dilatation is associated with bowel obstruction.…”