Is early delivery beneficial in gastroschisis?

Carnaghan, Helen; Pereira, Susana; James, CP; Charlesworth, Paul; Ghionzoli, Marco; Elkhouli, M.; Cross, Kate; Kiely, Edward M.; Patel, Shailesh; Desai, Ashish; Nicolaides, Kypros H.; Curry, Joseph I.; Ade-Ajayi, Niyi; Coppi, Paolo De; Davenport, Mark; David, Anna L.; Pierro, Agostino; Eaton, Simon

doi:10.1016/j.jpedsurg.2014.01.027

Cited by 56 publications

(47 citation statements)

References 28 publications

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“…Interestingly, in 2 cases, IABD seen during the second trimester regressed spontaneously, advocating for caution when interpreting this ultrasound finding early in pregnancy. In our cohort, we were not able to confirm the findings by Carnaghan et al [37], showing an increased predictive value when combining intra- and extra-abdominal loop assessment. It has been hypothesized that antenatal bowel dilatation is secondary to constriction at the defect site [38] and/or inflammatory changes of the intestinal bowel wall changes secondary to exposure to amniotic fluid constituents [28,39,40,41].…”

Section: Discussioncontrasting

confidence: 99%

Predicting Perinatal Outcome from Prenatal Ultrasound Characteristics in Pregnancies Complicated by Gastroschisis

Martillotti

Boucoiran²,

Damphousse³

et al. 2015

Fetal Diagn Ther

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Introduction: The objective of the study was to establish the predictive value of prenatal ultrasound markers for complex gastroschisis (GS) in the first 10 days of life. Material and Methods: In this retrospective cohort study over 11 years (2000-2011) of 117 GS cases, the following prenatal ultrasound signs were analyzed at the last second- and third-trimester ultrasounds: intrauterine growth restriction, intra-abdominal bowel dilatation (IABD) adjusted for gestational age, extra-abdominal bowel dilatation (EABD) ≥25 mm, stomach dilatation, stomach herniation, perturbed mesenteric circulation, absence of bowel lumen and echogenic dilated bowel loops (EDBL). Results: Among 114 live births, 16 newborns had complex GS (14.0%). Death was seen in 16 cases (13.7%): 3 intrauterine fetal deaths, 9 complex GS and 4 simple GS. Second-trimester markers had limited predictive value. Third-trimester IABD, EABD, EDBL, absence of intestinal lumen and perturbed mesenteric circulation were statistically associated with complex GS and death. IABD was able to predict complex GS with a sensitivity of 50%, a specificity of 91%, a positive predictive value of 47% and a negative predictive value of 92%. Discussion: Third-trimester IABD adjusted for gestational age appears to be the prenatal ultrasound marker most strongly associated with adverse outcome in GS.

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Section: Discussioncontrasting

confidence: 99%

Predicting Perinatal Outcome from Prenatal Ultrasound Characteristics in Pregnancies Complicated by Gastroschisis

Martillotti

Boucoiran²,

Damphousse³

et al. 2015

Fetal Diagn Ther

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show abstract

“…26,27 The results of other studies are not consistent with this latter observation. 28,29 In our study, results showed a tendency that correlated shorter survival with a lower birth weight when specifically examining esophageal atresia and myelomeningocele; however, this association was not statistically significant. As per the bibliography, low birth weight is a risk factor for the survival of newborn infants with CAs.…”

Section: Discussioncontrasting

confidence: 63%

Study on the prevalence and neonatal lethality in patients with selected congenital anomalies as per the data of the National Registry of Congenital Anomalies of Argentina

2015

Arch Argent Pediat

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“…Concordant with the presented course, it has been described that the presence of meconium or blood-stained amniotic fluid and either prenatal or postnatal gastrointestinal complications is associated with an older age to reach full enteral feeds [16]. Therefore, the reported infant suffered from type 2 intestinal failure, requiring >28 days of parenteral nutrition [15].…”

Section: Discussionsupporting

confidence: 61%

“…Early elective delivery for suspected complex cases of gastroschisis is normally advocated in order to prevent the development of bowel necrosis secondary to the abdominal events. However, a recently published multi-institutional study did not reveal any benefit to the elective delivery at <37 weeks of gestation [15].…”

Section: Discussionmentioning

confidence: 91%

“Inverse Type” Apple-Peel Syndrome Is Associated with Type III Colonic Atresia in a Neonate with Gastroschisis—A “New” Subtype of Colonic Atresia

Tröbs¹,

Bahr²,

Schulze³

et al. 2015

OJPed

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The colon is an unusual site of intestinal atresia. Colonic atresia is subdivided into three phenotypes. Type III is the most common phenotype, where the proximal and distal blind sacs are not connected. Here, we report on the presence of colonic atresia with an "inverse apple-peel" appearance in a neonate with gastroschisis. The lack of mesenteric fixation of the entire small intestine, including the proximal colon, and the twisting around the vascular axis of the superior mesenteric artery led to intrauterine volvulus and hemorrhagic infarction of the ileocolic bowel at 34 weeks of gestation. According to the current nomenclature for small bowel atresia, we introduce type IIIB into the current colonic atresia classification. The occurrence of type IIIB has been mentioned in the literature, but no single cases have been reported until now. Patients with this type of atresia are predisposed to the loss of the ileocecal region.

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Is early delivery beneficial in gastroschisis?

Abstract: Early delivery is associated with prolonged ENT/LOS, suggesting elective delivery at <37weeks is not beneficial. Combined IABD/EABD or IABD/collapsed extra-abdominal bowel is suggestive of complex gastroschisis.

Cited by 56 publications

References 28 publications

Predicting Perinatal Outcome from Prenatal Ultrasound Characteristics in Pregnancies Complicated by Gastroschisis

Predicting Perinatal Outcome from Prenatal Ultrasound Characteristics in Pregnancies Complicated by Gastroschisis

Study on the prevalence and neonatal lethality in patients with selected congenital anomalies as per the data of the National Registry of Congenital Anomalies of Argentina

“Inverse Type” Apple-Peel Syndrome Is Associated with Type III Colonic Atresia in a Neonate with Gastroschisis—A “New” Subtype of Colonic Atresia

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