Analysis of the clinical outcomes of fetal bowel dilatation combined with other abnormal ultrasonographic features

Xu, Suting; Zhong, Wei; Shen, Zhuanxing; Dai, Chang-Ping; Xia, Huimin; Guan, Qiansi; Bai, Lihua; Yu, Jian

doi:10.1080/14767058.2017.1397123

Cited by 7 publications

(16 citation statements)

References 12 publications

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“…Different prognostic factors were identified: (1) the presence or not of associated malformations, (2) the result of complementary tests in amniotic fluid, (3) the progression of dilatation between two US examinations, and (4) MRI to confirm the level of obstruction. These prognostic factors have been described in the literature but frequently independently, 15–22 and we propose a policy to improve the management of pregnancies.…”

Section: Discussionmentioning

confidence: 83%

“…The first step of management could be a specialized US scan to screen for digestive or non‐digestive associated anomalies, because their absence is a predictor of good prognosis ( p < 0.001) as previously reported 3,4,8,15–19 . However, of the 112 live infants, 12 (10.7%) presented with an additional severe intestinal or non‐intestinal malformation not detected prenatally, thereby modifying postnatal care.…”

Section: Discussionmentioning

confidence: 94%

“…MRI was performed in 54 cases between 26 and 37 weeks (median 32 weeks). The results are presented in These prognostic factors have been described in the literature but frequently independently, [15][16][17][18][19][20][21][22] and we propose a policy to improve the management of pregnancies.…”

Section: Prenatal Magnetic Resonance Imagingmentioning

confidence: 91%

“…The first step of management could be a specialized US scan to screen for digestive or non-digestive associated anomalies, because their absence is a predictor of good prognosis (p < 0.001) as previously reported. 3,4,8,[15][16][17][18][19] However, of the 112 live infants, 12 (10.7%)…”

Section: Prenatal Magnetic Resonance Imagingmentioning

confidence: 99%

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Fetal intestinal loop dilatation: Follow‐up and outcome of a series of 133 consecutive cases (the DILDIG study)

et al. 2023

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Objectives: To define the prognostic markers of fetal dilated bowel loops.Methods: National non-interventional study of 133 consecutive prenatal observations of dilated loops including ultrasound examinations, complementary laboratory tests, magnetic resonance imaging (MRI), outcomes, and postnatal diagnosis.Results: One hundred twenty seven cases were classified according to outcome: Group 1, very severe (n = 43), Group 2, children needing specific care (n = 39), and Group 3, healthy children (n = 45). Prenatal ultrasound scan suggested duodenal obstruction in 30 cases, small bowel obstruction in 81, colonic obstruction in 11, and diffuse dilatation in 5. Diameter of dilated loops did not significantly differ between the groups. A poor prognosis was significantly associated with duodenal obstruction, genetic anomalies (53% vs. 21.8%), including aneuploidies or CFTR gene mutations and abnormal amniotic fluid biochemistry (86.4% vs. 38.7%). A good prognosis was associated with regression of dilatation and normal MRI. Conclusion:In this study, postnatal outcomes for fetuses with intestinal dilatation were best predicted by assessing the level of obstruction with prenatal ultrasound and MRI, determining the presence of associated malformations, amniotic fluid biochemical and genetic testing, and monitoring for regression of bowel dilatation.These results should help inform future guidelines on the prenatal and neonatal management of congenital intestinal obstruction.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 94%

Section: Prenatal Magnetic Resonance Imagingmentioning

confidence: 91%

Section: Prenatal Magnetic Resonance Imagingmentioning

confidence: 99%

See 2 more Smart Citations

Fetal intestinal loop dilatation: Follow‐up and outcome of a series of 133 consecutive cases (the DILDIG study)

et al. 2023

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“…Polyhydramnios occurs in approximately 1%-2% of pregnancies 7,8 while bowel dilation is found in 3.91% of ultrasound abnormalities. 9 Both of these symptoms can temporarily or persistently exist, and are associated with various factors without specificity. Polyhydramnios is commonly associated with fetal and maternal disease in addition to idiopathic.…”

Section: Discussionmentioning

confidence: 99%

Two cases of microvillus inclusion disease caused by MYO5B deficiency with prenatal abnormalities

Lü

Ding

et al. 2021

Prenatal Diagnosis

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Backgrounds: Microvillus inclusion disease (MVID) characterizes as intractable lifethreatening watery diarrhea malnutrition after birth.Materials & Methods: Here we describe two patients with prenatal ultrasound findings of bowel dilation or increased amniotic fluid volume presented intractable diarrhea after birth. Exome sequencing and Intestinal biopsy were performed for the patients and their parents to reveal the underlying causes. The mutations were verified by Sanger sequencing and quantitative polymerase chain reaction.Results: Exome sequencing revealed that both of the patients carrying MYO5B compound heterozygote mutations that were inherited from their parents. Conclusion:Here we describe two cases with MVID caused by MYO5B deficiency, which was the most common caused with prenatal ultrasound findings of bowel dilation and increased amniotic fluid volume. Due to the lack of effective curative therapies, early diagnosis even in prenatal of MVID can provide parents with better genetic counseling on the fetal prognosis. Key pointsWhat's already known about this topic? � Microvillus inclusion disease (MVID) is characterized by intractable life-threatening watery diarrhea and malnutrition after birth and lacks effective treatment. What does this study add?� Previous cases have reported infantile diarrhea syndrome after birth in cases of MVID. In the two cases presented here, both fetuses presented with generalized bowel dilation and increased amniotic fluid volume, which mimicked intestinal obstruction on the prenatal ultrasound. These cases expand the prenatal phenotype profile of MIVD. | INTRODUCTIONMicrovillus inclusion disease (MVID) is characterized as intractable life-threatening watery diarrhea and malnutrition after birth, and patients with MVID have a high rate of death before 9 months of age. 1 MVID is classified as early one-set (occurring after birth) or late one-set (occurring at 3 or 4 months of age) depends on the time of onset of the diarrhea. Recent studies have found that MVID is ascribed to MYO5B, STX3, and STXBP2 deficiencies. 2 Here, we report two patients who both presented with bowel dilation and increased amniotic fluid volume on prenatal ultrasound and had MVID and MYO5B compound heterozygote mutations. | CLINICAL PRESENTATIONCase 1 is a 2-day-old neonate transferred to our hospital for metabolic acidosis, dehydration, electrolyte disturbances, and jaundice. She was 136 -Prenatal Diagnosis.

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Congenital small bowel obstruction: Prenatal detection and outcome

Heinrich,

Pijpers,

Linskens

et al. 2023

Prenatal Diagnosis

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ObjectiveTo evaluate and compare the outcome of fetuses and neonates with congenital small bowel obstructions (SBO), evaluate the screening performance of prenatal ultrasound for SBO and identify possible risk factors for adverse outcomes.MethodsAll cases referred to the Amsterdam University Medical Centers between 2007 and 2021 for a prenatal suspected SBO, supplemented by cases of postnatal diagnosis of SBO, were included. The primary outcome was survival after 24 weeks of gestation until the first year of life.Results147 cases of SBO were included with a survival rate of 86.2% (119/138) after 24 weeks of gestation until the first year of age. Additional structural or chromosomal anomalies were found to have an increased risk of adverse outcomes. Intrauterine fetal demise occurred in 10/147 (6.8%) cases and 9/147 (6.1%) cases died during postnatal follow‐up. The overall positive predictive value of all prenatally diagnosed cases was 91.5%. Surgical correction was performed in 123/128 (96.0%) of the live‐born cases.ConclusionsCongenital SBO has an overall favorable prognosis, but the outcome is negatively impacted by the possible presence of additional structural or chromosomal anomalies. Fetal monitoring in the early third trimester should be considered, since all cases of Intrauterine fetal demise occurred between 30 and 35 weeks of gestation.

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Analysis of the clinical outcomes of fetal bowel dilatation combined with other abnormal ultrasonographic features

Cited by 7 publications

References 12 publications

Fetal intestinal loop dilatation: Follow‐up and outcome of a series of 133 consecutive cases (the DILDIG study)

Fetal intestinal loop dilatation: Follow‐up and outcome of a series of 133 consecutive cases (the DILDIG study)

Two cases of microvillus inclusion disease caused by MYO5B deficiency with prenatal abnormalities

Congenital small bowel obstruction: Prenatal detection and outcome

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