Premium
Prenatal ultrasound in the prediction of bowel obstruction in infants with gastroschisis
Author(s) -
Contro E.,
Fratelli N.,
Okoye B.,
Papageorghiou A.,
Thilaganathan B.,
Bhide A.
Publication year - 2010
Publication title -
ultrasound in obstetrics and gynecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.202
H-Index - 141
eISSN - 1469-0705
pISSN - 0960-7692
DOI - 10.1002/uog.7514
Subject(s) - medicine , gastroschisis , bowel obstruction , prenatal diagnosis , surgery , ultrasound , fetus , bowel resection , abdominal wall , obstetrics , pregnancy , radiology , genetics , biology
Objective To assess the value of prenatal ultrasound in predicting bowel obstruction requiring surgery in fetuses with prenatal diagnosis of gastroschisis. Methods The database of our center was searched for cases with an antenatal diagnosis of gastroschisis. The ultrasound images were reviewed blindly to assess the presence of intra‐ or extra‐abdominal bowel dilatation. Details of surgical procedures were noted and the discharge letters were obtained. Pediatric follow‐up was also obtained from pediatric surgeons, general practitioners or parents. Results In the 10‐year period between November 1998 and September 2008 there were 62 cases with a prenatal diagnosis of gastroschisis. Postnatal outcome was not available for five cases, four pregnancies underwent termination and intrauterine fetal demise occurred in five cases. A final population of 48 liveborn infants was available for analysis. Intra‐abdominal bowel dilatation was identified in 14 of these 48 fetuses (29.2%) and extra‐abdominal bowel dilatation in 30 (62.5%) fetuses on prenatal ultrasound images. Eight fetuses (16.7%) had bowel obstruction. The relative risk of bowel obstruction with intra‐abdominal bowel dilatation was 4.05 (95% CI, 1.12–14.70). On the other hand, the relative risk of bowel obstruction with extra‐abdominal bowel dilatation was 1.0 (95% CI, 0.37–3.70). Four babies died, two of whom had intra‐ and one had extra‐abdominal bowel dilatation. Conclusions Intra‐abdominal dilatation of the bowel on prenatal ultrasound examination appears to predict postnatal bowel obstruction and the need for surgical resection. Extra‐abdominal bowel dilatation is observed frequently on prenatal ultrasound scans, but is not predictive of bowel obstruction. Copyright © 2009 ISUOG. Published by John Wiley & Sons, Ltd.