Fetal Bowel Dilatation: A Sonographic Sign of Uncertain Prognosis

Silva, Patrícia; Reis, Filipa; Alves, Paulo; Farinha, Luí­s; Gomes, M. S.; Camara, P.-Y.

doi:10.1155/2015/608787

Cited by 12 publications

(16 citation statements)

References 14 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%

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%

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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“…There are multiple reasons, functional and mechanical, why fetal bowel obstruction occurs, such as congenital disorder, intestinal malrotation/volvulus, and even meconium plug syndrome. 2,3 Identifying the etiology, nonetheless, remains difficult due to the limited accuracy of ultrasound imaging. As such, this requires prompt attention from the neonatal specialists as well as pediatric surgeons and careful work-up is warranted in order to devise a proper treatment.…”

Section: Questions/discussion: Partmentioning

confidence: 99%

Educational Case: Intrauterine Fetal Demise and Intestinal Atresia: An Autopsy Investigation

Kuan

Reznik

2020

Academic Pathology

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The following fictional case is intended as a learning tool within the Pathology Competencies for Medical Education (PCME), a set of national standards for teaching pathology. These are divided into three basic competencies: Disease Mechanisms and Processes, Organ System Pathology, and Diagnostic Medicine and Therapeutic Pathology. For additional information, and a full list of learning objectives for all three competencies, see http://journals.sagepub.com/doi/10.1177/2374289517715040 .1

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“…In our case, maternal ultrasound up to the 29 th week was reported as normal but routine third trimester ultrasound showed dilated bowel loops. Dilated bowel loops are highly indicative of bowel obstruction due to a congenital disorder, intestinal malrotation, volvulus, and meconium plug syndrome (13).…”

Section: A B Cmentioning

confidence: 99%

Apple peel deformity and malrotation of gut: autopsy findings of a rare cause of mortality in utero

Mutreja¹,

Singh²

2021

TJPATH

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One-third of all intestinal obstructions in the newborn are caused by atresias. The most common site is the duodenum followed by jejunoileal and colonic locations. Herein we report the autopsy findings of a rare case of jejunoileal atresia associated with malrotation of gut. Autopsy performed on a 36 weeks old male fetus still birth, born of a non-consanguineous marriage, demonstrated jejunoileal atresia with apple peel deformity and malrotation of gut. Although the diagnosis was established in the prenatal period, in utero fetal demise occurred before definitive surgical intervention could be done. This case highlights the importance of early diagnosis and intervention.

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Fetal Bowel Dilatation: A Sonographic Sign of Uncertain Prognosis

Cited by 12 publications

References 14 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)

Educational Case: Intrauterine Fetal Demise and Intestinal Atresia: An Autopsy Investigation

Apple peel deformity and malrotation of gut: autopsy findings of a rare cause of mortality in utero

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