Clinical significance of prenatal ultrasonographic intestinal dilatation in fetuses with gastroschisis

Alsulyman, Owaidah M.; Monteiro, Hamilton Antônio de Oliveira; Ouzounian, Joseph G.; Barton, Lorayne; Songster, Giuliana S.; Kovacs, Bruce W.

doi:10.1016/s0002-9378(96)80037-8

Cited by 62 publications

(52 citation statements)

References 10 publications

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“…15,28,29 Others, however, report that herniated bowel dilatation does not predict a poor outcome. 30,31 Our data support the latter studies in that there was no difference in outcome between fetuses with a dilated bowel prenatally compared with those without bowel dilatation. Further studies are needed to determine whether other sonographic findings can help predict outcome in fetuses with gastroschisis.…”

Section: Discussionsupporting

confidence: 86%

Postnatal Outcome of Fetuses With the Prenatal Diagnosis of Gastroschisis

Durfee

Downard

Benson

et al. 2002

Journal of Ultrasound in Medicine

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Objective. To assess the postnatal outcome and complications that arise in infants with the prenatal diagnosis of gastroschisis. Methods. Prenatal sonograms with the diagnosis of gastroschisis were identified. Maternal age, indication for sonography, gestational age at diagnosis, other sonographic abnormalities, and postnatal outcome were recorded. Results. Twenty-six fetuses at 16 to 36 weeks' gestational age had gastroschisis diagnosed on sonography. In 5 cases, other fetal anomalies were identified, including hydronephrosis and asymmetric hydrocephalus. In 9 of 21 cases followed by serial prenatal sonography, bowel dilatation developed, prompting delivery in 2. Two of the 26 study fetuses were electively terminated. The remaining 24 were born live and had immediate repair of the gastroschisis after birth. Nineteen infants (79%) had postnatal complications, some with multisystem complications, including 3 deaths, 10 with gastrointestinal complications, 6 with infectious complications, and 6 with anomalies involving other systems (genitourinary, cardiac, central nervous system, and respiratory). Only 5 infants (21%) had completely uncomplicated postsurgical courses. Hospital stays for survivors ranged from 10 to 98 days (mean, 38 days; median, 33 days). Conclusions. Although reported survival rates are good for gastroschisis, the postoperative hospital stay is often lengthy, and complications are very common, especially those related to the gastrointestinal tract. Other anomalies are uncommon but not rare.

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Section: Discussionsupporting

confidence: 86%

Postnatal Outcome of Fetuses With the Prenatal Diagnosis of Gastroschisis

Durfee

Downard

Benson

et al. 2002

Journal of Ultrasound in Medicine

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“…The ability to affect neonatal outcomes is compromised by the lack of widespread agreement regarding which ultrasound findings are predictive of postnatal bowel pathology, and, in turn, complicated neonatal courses. The presence of bowel dilation as a prognostic factor has been investigated in several studies; however, a consensus has not yet emerged from such work [1,3,10,11,12,13]. The absence of strong prognostic factors limits the ability of obstetricians to identify fetuses at risk of complicated neonatal courses, appropriately counsel families, and notify neonatal and pediatric surgical teams accordingly.…”

Section: Discussionmentioning

confidence: 99%

Is Preterm Delivery Indicated in Fetuses with Gastroschisis and Antenatally Detected Bowel Dilation?

Wilson

Carroll

Braün³

et al. 2012

Fetal Diagn Ther

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Introduction: Due to the controversy surrounding diagnostic ultrasound evaluations and elective preterm delivery of fetuses with gastroschisis, we sought to calculate the predictive value of bowel dilation in fetuses with gastroschisis and evaluate the effect of preterm delivery on neonatal outcomes. Materials and Methods: Ultrasounds and medical records of 103 mother-infant pairs with fetal gastroschisis were reviewed. Eighty-nine pairs met the criteria. Intestinal complications, gestational age at delivery, birth weight, and number of abdominal surgeries were documented. Results: Forty-eight fetuses (54%) had bowel dilation and 41 (46%) did not. The positive predictive value of bowel dilation for complicated gastroschisis was 21%. There were 50 (56%) preterm and 39 (44%) term deliveries. The mean birth weight was 2,114 g (SD = 507) and 2,659 g (SD = 687), p = 0.001. For infants delivered preterm, the mean number of postnatal abdominal surgeries was 2.1 (SD = 1.1) as compared to 1.3 (SD = 0.5) surgical procedures for those infants delivered at term gestation. This was not statistically significant. With respect to hospital stay for each group, the mean length of neonatal intensive care unit admission was 48 days (SD = 33) in the preterm group and 35 days (SD = 50) in the term group, which was not statistically significant. Discussion: Ultrasound-detected bowel dilation was not predictive of important intestinal complications. Our data did not substantiate any benefit for elective preterm delivery of neonates with gastroschisis.

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“…Bowel wall thickness and bowel dilatation has been evaluated and has not been predictive of immediate neonatal outcome. This finding was not recommended as an appropriate indication for preterm delivery in the absence of other evidence of fetal compromise [48,49].…”

Section: Prenatal Evaluation Including Differential Diagnosismentioning

confidence: 96%

Congenital Abdominal Wall Defects: An Update

Wilson¹,

Johnson²

2004

Fetal Diagn Ther

156

122

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Objective: To review published peer-reviewed literature regarding abdominal wall defects including gastroschisis and omphalocele. Methods: Review of published peer-reviewed literature using Med Line 1985–2003 and textbooks. Results: Gastroschisis and omphalocele literature is reviewed using pathology, incidence and epidemiology, prenatal evaluation, pregnancy and delivery management, postnatal outcome and fetal therapy. Conclusion: Gastroschisis and omphalocele are common abdominal wall defects and have significant morbidity and mortality.

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Clinical significance of prenatal ultrasonographic intestinal dilatation in fetuses with gastroschisis

Cited by 62 publications

References 10 publications

Postnatal Outcome of Fetuses With the Prenatal Diagnosis of Gastroschisis

Postnatal Outcome of Fetuses With the Prenatal Diagnosis of Gastroschisis

Is Preterm Delivery Indicated in Fetuses with Gastroschisis and Antenatally Detected Bowel Dilation?

Congenital Abdominal Wall Defects: An Update

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