Severity of intestinal damage in gastroschisis: Correlation with prenatal sonographic findings

Gastroschisis: can sonography of the fetal bowel accurately predict postnatal outcome?

“…Although reviewed retrospectively, the images had been obtained under the assumption that the appearance of the bowel may influence prognosis and potentially lead to preterm delivery. 4 These targeted examinations likely recorded images of the most abnormal bowel loops visualized. Each observer also gave an overall subjective impression of the condition of the bowel (normal, equivocal, or abnormal).…”

“…Because prognosis for the infant born with gastroschisis depends primarily on the condition of the bowel at birth, researchers sought to find sonographic predictors of bowel damage that could be followed prenatally and used to make decisions about the timing of delivery. 4 In 1988, Bond and colleagues reported that subjectively determined small bowel dilation and bowel wall thickening on prenatal sonography correlated with postnatal bowel abnormality and poor clinical outcome. 4 This conclusion was based on findings in four fetuses who demonstrated both sonographic features.…”

“…4 In 1988, Bond and colleagues reported that subjectively determined small bowel dilation and bowel wall thickening on prenatal sonography correlated with postnatal bowel abnormality and poor clinical outcome. 4 This conclusion was based on findings in four fetuses who demonstrated both sonographic features. Since this report, fetuses have been followed to identify these changes in the bowei.…”

Predictive factors at birth of the severity of gastroschisis

“…It appears, however, that antenatal screening cannot reliably predict morbidity, and the fact that no consensus emerges from the different studies is due mainly to the small sample size, but also to the difficulty in correlating imaging findings with clinical outcome. Some studies found a significant association between intra-abdominal bowel dilation and bowel atresia [5,17,18] . Japaraj et al [6] found that the occurrence of polyhydramnios was significantly associated with a higher rate of severe bowel com plications such as atresia, perforation and necrosis.…”

“…A prenatal ultrasound (US) diagnosis makes it possible to inform and prepare the parents, even though it remains difficult to predict whether the affected children will have a high or a low risk of abdominal complications, and how long they will need to be hospitalized [5,6] . If the defect closes by itself before birth, ischemia of the bowel may provoke total bowel necrosis.…”