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P36Prenatally diagnosed duodenal obstruction: a report of 16 cases
Author(s) -
Galindo A.,
Arbues J.,
Puente J. M.,
Villar O.,
Cano I.,
Grañeras A.,
De La Fuente P.
Publication year - 2000
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 - 10.1046/j.1469-0705.2000.00004-1-36.x
Subject(s) - medicine , polyhydramnios , duodenal atresia , annular pancreas , trisomy , bowel obstruction , gestational age , incidence (geometry) , pregnancy , atresia , obstetrics , fetus , prenatal diagnosis , retrospective cohort study , pediatrics , gastroenterology , surgery , duodenum , genetics , physics , optics , biology
Aim To evaluate main ultrasound findings, associated anomalies and perinatal outcome of fetuses with duodenal obstruction (DO). Methods Retrospective review from January 1990 to October 1998 of 16 fetuses with DO. Results The incidence was 1 in 2771 deliveries. DO accounted for 53% (16/30) of all the small bowel obstructions. Sensitivity was 76%. Mean gestational age at diagnosis was 32.6 weeks. Associated anomalies were diagnosed prenatally in 5 cases (31.3%) and postnatally in 3 more cases, so associated anomalies were present in 50%. DO was an isolated finding in 11 cases (68.7%) and no chromosomal anomalies were observed in this group. These were diagnosed in 4 out of the 5 cases with associated anomalies. Polyhydramnios was quite common (93.7%). Taking into account also cases postnatally diagnosed, chromosomal defects rate was 33.3% (trisomy 21 represents 86% of all). Mean gestational age at delivery was 35.1 weeks. Mean weight at birth was 2315 g. Perinatal mortality rate for prenatally diagnosed DO cases was 31.2%, but this rate rose up to 62.5% in those cases with associated anomalies. No deaths were seen in isolated cases. DO resulted from atresia in 6 cases (37.5%), from web in 5 (31.2%) and from annular pancreas in 5 (31.2%). Conclusion DO is most prevalent type of small bowel obstruction. Associated anomalies and chromosomal defects (Tr.21) are common and should always be ruled out. While isolated cases have good prognosis, outcome is worse with associated anomalies, the latter being the major prognostic factor.